| NPI | 1538515176 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2086S0129X Surgery, Vascular Surgery (Licence: CT 74644) |
| Additional Taxonomies | 2086S0129X Surgery, Vascular Surgery (Licence: MO 2021023214) |
| 2086S0129X Surgery, Vascular Surgery (Licence: RI MD19347) | |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2016-05-13 |
| Last Update Date | 2023-11-03 |