| NPI | 1932420353 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208600000X Surgery (Licence: NC 2022-02861) |
| Additional Taxonomies | 2086S0129X Surgery, Vascular Surgery (Licence: VA 0101251127) |
| 2086S0129X Surgery, Vascular Surgery (Licence: NC 2022-02861) | |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2010-06-21 |
| Last Update Date | 2024-02-22 |