| NPI | 1184643629 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: CA A102905) |
| Additional Taxonomies | 202K00000X Phlebology (Licence: CA A102905) |
| Enumeration Date | 2006-07-18 |
| Last Update Date | 2025-05-05 |