| NPI | 1902429277 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 390200000X Student in an Organized Health Care Education/Training Program |
| Additional Taxonomies | 2086S0127X Surgery, Trauma Surgery (Licence: TX W3522) |
| Enumeration Date | 2020-05-21 |
| Last Update Date | 2026-06-03 |