| NPI | 1184610453 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0129X Surgery Vascular Surgery (Licence: FL OS9545) |
| Additional Taxonomies | 202K00000X Phlebology (Licence: FL OS9545) |
| Enumeration Date | 2005-09-22 |
| Last Update Date | 2025-03-06 |