| NPI | 1992191142 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2086S0127X Surgery, Trauma Surgery (Licence: OH 35.129627) |
| Additional Taxonomies | 208600000X Surgery (Licence: OH 35.129627) |
| 208600000X Surgery (Licence: FL ME144893) | |
| 2086S0102X Surgery, Surgical Critical Care (Licence: OH 35.129627) | |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2015-04-14 |
| Last Update Date | 2022-04-07 |