| NPI | 1760879308 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2086S0129X Surgery, Vascular Surgery (Licence: IN 02007458A) |
| Additional Taxonomies | 2086S0129X Surgery, Vascular Surgery (Licence: OH 34.014465) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2015-04-21 |
| Last Update Date | 2023-11-08 |