| NPI | 1891914206 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0129X Surgery Vascular Surgery (Licence: AZ 59413) |
| Additional Taxonomies | 208600000X Surgery (Licence: NE 4967) |
| 2086S0129X Surgery Vascular Surgery (Licence: SC 34014) | |
| 2086S0129X Surgery Vascular Surgery (Licence: MN 52443) | |
| 2086S0129X Surgery Vascular Surgery (Licence: NE 30039) | |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2007-04-24 |
| Last Update Date | 2022-03-30 |