| NPI | 1912369471 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0129X Surgery Vascular Surgery (Licence: OH 35.150142) |
| Additional Taxonomies | 2086S0129X Surgery Vascular Surgery (Licence: GA 14084) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2016-03-24 |
| Last Update Date | 2024-05-24 |