| NPI | 1992091128 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0102X Surgery, Surgical Critical Care (Licence: NC 2019-00821) |
| Additional Taxonomies | 208600000X Surgery (Licence: NC 2019-00821) |
| 208600000X Surgery (Licence: KY 49337) | |
| 2086S0102X Surgery, Surgical Critical Care (Licence: KY 49337) | |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2011-06-27 |
| Last Update Date | 2022-11-18 |