| NPI | 1255385498 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207N00000X Dermatology (Licence: MD D046607) |
| Additional Taxonomies | 202K00000X Phlebology (Licence: MD D0046607) |
| 207NS0135X Dermatology Procedural Dermatology (Licence: MD D0046607) | |
| 2086S0129X Surgery Vascular Surgery (Licence: MD D0046607) | |
| Enumeration Date | 2006-05-20 |
| Last Update Date | 2019-02-16 |