| NPI | 1225272289 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 202K00000X Phlebology (Licence: AZ 928) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: AZ 011209) |
| 2086S0129X (Licence: AZ 011209) | |
| Enumeration Date | 2009-04-21 |
| Last Update Date | 2025-02-27 |