| NPI | 1427201359 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0129X Surgery Vascular Surgery (Licence: FL ME152784) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
| 2086S0129X Surgery Vascular Surgery (Licence: PA MD446408) | |
| Enumeration Date | 2008-10-23 |
| Last Update Date | 2021-11-03 |