| NPI | 1043216336 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 202K00000X Phlebology (Licence: KS 04-26621) |
| Additional Taxonomies | 202K00000X Phlebology (Licence: MO 106409) |
| Enumeration Date | 2005-06-22 |
| Last Update Date | 2021-07-01 |