NPI | 1659418937 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 2086S0129X Surgery, Vascular Surgery (Licence: CO DR0051583) |
Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: CO TL-2055) |
Enumeration Date | 2007-01-30 |
Last Update Date | 2016-02-11 |