| NPI | 1588105811 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0129X Surgery, Vascular Surgery (Licence: LA 338178) |
| Additional Taxonomies | 2086S0129X Surgery, Vascular Surgery (Licence: IL 125.072356) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2017-03-20 |
| Last Update Date | 2023-12-06 |