| NPI | 1962934075 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0127X Surgery, Trauma Surgery (Licence: WI 81168) |
| Additional Taxonomies | 2086S0127X Surgery, Trauma Surgery (Licence: IL 036-173202) |
| 208D00000X General Practice (Licence: AZ 008084) | |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2017-03-29 |
| Last Update Date | 2025-04-22 |