NPI | 1154859049 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 2086S0129X Surgery, Vascular Surgery (Licence: AL MD.49313) |
Additional Taxonomies | 208600000X Surgery (Licence: AL MD.49313) |
390200000X Student in an Organized Health Care Education/Training Program | |
Enumeration Date | 2017-05-23 |
Last Update Date | 2024-09-16 |