| NPI | 1659418937 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0129X Surgery, Vascular Surgery (Licence: CO DR0051583) |
| Additional Taxonomies | 202K00000X (Licence: CO DR0051583) |
| 390200000X Student in an Organized Health Care Education/Training Program (Licence: CO TL-2055) | |
| Enumeration Date | 2007-01-30 |
| Last Update Date | 2025-02-15 |