| NPI | 1932583796 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 390200000X Student in an Organized Health Care Education/Training Program |
| Additional Taxonomies | 208600000X Surgery (Licence: AZ 208600000X) |
| Enumeration Date | 2015-07-11 |
| Last Update Date | 2019-08-14 |