NPI | 1144225319 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 202K00000X Phlebology (Licence: IL 036114542) |
Additional Taxonomies | 174400000X Specialist (Licence: OH 35063661) |
Enumeration Date | 2005-06-15 |
Last Update Date | 2018-10-31 |