| NPI | 1952622847 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0102X Surgery, Surgical Critical Care (Licence: CO DR.0057328) |
| Additional Taxonomies | 208600000X Surgery (Licence: CO DR.0057328) |
| 390200000X Student in an Organized Health Care Education/Training Program (Licence: IL 125058718) | |
| 2086S0102X Surgery, Surgical Critical Care (Licence: IL 036137526) | |
| Enumeration Date | 2010-06-15 |
| Last Update Date | 2016-08-02 |