| NPI | 1649690835 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0129X Surgery, Vascular Surgery (Licence: GA 83005) |
| Additional Taxonomies | 208D00000X General Practice (Licence: LA 301277) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2014-04-26 |
| Last Update Date | 2023-11-29 |