NPI | 1306305628 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 2086S0129X Surgery, Vascular Surgery (Licence: NC 2024-01730) |
Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
Enumeration Date | 2019-03-16 |
Last Update Date | 2024-09-26 |