| NPI | 1215215371 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0129X Surgery, Vascular Surgery (Licence: TX S8168) |
| Additional Taxonomies | 2086S0129X Surgery, Vascular Surgery (Licence: OR MD175917) |
| 390200000X Student in an Organized Health Care Education/Training Program (Licence: TX BP10041450) | |
| Enumeration Date | 2011-07-23 |
| Last Update Date | 2024-01-09 |