NPI | 1932562980 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 208600000X Surgery (Licence: ID M-15782) |
Additional Taxonomies | 208600000X Surgery (Licence: PA MT213453) |
390200000X Student in an Organized Health Care Education/Training Program | |
Enumeration Date | 2016-03-29 |
Last Update Date | 2021-09-01 |