| NPI | 1558721167 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0129X Surgery, Vascular Surgery (Licence: PA OS019891) |
| Additional Taxonomies | 2086S0129X Surgery, Vascular Surgery (Licence: PA FF2923515) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2016-02-25 |
| Last Update Date | 2024-10-22 |