| NPI | 1861756892 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0129X Surgery, Vascular Surgery (Licence: VT 042.0014297) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: VT 060.0004719) |
| 2086S0129X Surgery, Vascular Surgery (Licence: NY 305863) | |
| Enumeration Date | 2012-06-25 |
| Last Update Date | 2020-08-10 |