| NPI | 1588863120 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0129X Surgery, Vascular Surgery (Licence: NM MD2013-0071) |
| Additional Taxonomies | 2086S0129X Surgery, Vascular Surgery (Licence: MN 54564) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2007-07-13 |
| Last Update Date | 2024-10-10 |