| NPI | 1932635323 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0129X Surgery, Vascular Surgery (Licence: PA MD477436) |
| Additional Taxonomies | 2086S0129X Surgery, Vascular Surgery (Licence: PA MT213414) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2017-05-04 |
| Last Update Date | 2022-11-10 |