| NPI | 1578092193 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0129X Surgery, Vascular Surgery (Licence: OR MD218720) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
| 208600000X Surgery (Licence: OR MD218720) | |
| Enumeration Date | 2017-06-07 |
| Last Update Date | 2024-07-25 |