| 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 |