| NPI | 1992597975 |
|---|---|
| Entity Type | Individual |
| Gender | N/A |
| Sole Proprietor ? | No |
| Primary Taxonomy | 390200000X Student in an Organized Health Care Education/Training Program |
| Additional Taxonomies | 208600000X Surgery (Licence: TX BP10094683) |
| Enumeration Date | 2025-05-19 |
| Last Update Date | 2026-05-26 |