NPI | 1972869964 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 208600000X Surgery (Licence: TX T4514) |
Additional Taxonomies | 208600000X Surgery (Licence: TX 47265) |
390200000X Student in an Organized Health Care Education/Training Program | |
Enumeration Date | 2012-04-04 |
Last Update Date | 2022-07-26 |