NPI | 1477086767 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 2086S0129X Surgery, Vascular Surgery (Licence: NC 2022-01613) |
Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: NC 227759) |
Enumeration Date | 2017-04-04 |
Last Update Date | 2024-08-14 |