NPI | 1972820355 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 2086S0129X Surgery, Vascular Surgery (Licence: OR MD196678) |
Additional Taxonomies | 2086S0129X Surgery, Vascular Surgery (Licence: OK 30199) |
390200000X Student in an Organized Health Care Education/Training Program (Licence: TX BP10037253) | |
Enumeration Date | 2010-04-26 |
Last Update Date | 2023-09-19 |