NPI | 1932256815 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 208600000X Surgery (Licence: TX W0737) |
Additional Taxonomies | 208600000X Surgery (Licence: TN MD0000041437) |
208600000X Surgery (Licence: NY 268216-1) | |
390200000X Student in an Organized Health Care Education/Training Program | |
Enumeration Date | 2007-01-04 |
Last Update Date | 2025-09-02 |