| NPI | 1962896274 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0129X Surgery Vascular Surgery (Licence: CA A181237) |
| Additional Taxonomies | 208600000X Surgery (Licence: CO DR.0064566) |
| 2086S0129X Surgery Vascular Surgery (Licence: WY 16028A) | |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2015-03-25 |
| Last Update Date | 2024-02-24 |