| NPI | 1508063835 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0129X Surgery, Vascular Surgery (Licence: KS 0437333) |
| Additional Taxonomies | 208600000X Surgery (Licence: KS 0437333) |
| 390200000X Student in an Organized Health Care Education/Training Program (Licence: MO BS 5741663) | |
| 208600000X Surgery (Licence: MO 2012012809) | |
| 2086S0129X Surgery, Vascular Surgery (Licence: MO 2012012809) | |
| Enumeration Date | 2007-06-29 |
| Last Update Date | 2023-06-28 |