| NPI | 1073572533 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: NC 39366) |
| Additional Taxonomies | 202K00000X Phlebology (Licence: NC 39366) |
| Enumeration Date | 2006-03-22 |
| Last Update Date | 2023-08-07 |