| NPI | 1417290065 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0129X Surgery, Vascular Surgery (Licence: LA 324586) |
| Additional Taxonomies | 2086S0129X Surgery, Vascular Surgery (Licence: LA 296652) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2013-04-02 |
| Last Update Date | 2021-05-05 |