| NPI | 1992239446 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: MA 1027607) |
| Additional Taxonomies | 2086S0102X Surgery, Surgical Critical Care (Licence: MA 1027607) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2017-04-11 |
| Last Update Date | 2026-08-20 |