| NPI | 1275976458 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2086S0129X Surgery, Vascular Surgery (Licence: KS 04-45019) |
| Additional Taxonomies | 2086S0129X Surgery, Vascular Surgery (Licence: VA 0116033334) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2013-04-08 |
| Last Update Date | 2021-07-27 |