| NPI | 1689998551 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0129X Surgery, Vascular Surgery (Licence: OH 35.127921) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
| 2086S0129X Surgery, Vascular Surgery (Licence: MI 4301116672) | |
| Enumeration Date | 2010-03-22 |
| Last Update Date | 2019-01-17 |