NPI | 1457746463 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 2086S0129X Surgery, Vascular Surgery (Licence: NY 305058-01) |
Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
390200000X Student in an Organized Health Care Education/Training Program | |
Enumeration Date | 2015-04-06 |
Last Update Date | 2020-12-22 |