| NPI | 1912341835 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086H0002X Surgery, Hospice and Palliative Medicine (Licence: MA 288581) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
| Enumeration Date | 2013-04-22 |
| Last Update Date | 2021-12-03 |