NPI | 1235454497 |
---|---|
Former Name | BRANDON TYLER GARLAND |
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 2086S0129X Surgery, Vascular Surgery (Licence: CO DR.0055618) |
Additional Taxonomies | 2086S0129X Surgery, Vascular Surgery (Licence: WA MD60402101) |
Enumeration Date | 2010-03-31 |
Last Update Date | 2022-07-01 |