| NPI | 1336515295 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0129X Surgery, Vascular Surgery (Licence: MI 4301508401) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
| 208600000X Surgery (Licence: MI 4301508401) | |
| Enumeration Date | 2015-08-14 |
| Last Update Date | 2022-12-16 |