| NPI | 1285799841 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: OK 15655) |
| Additional Taxonomies | 202K00000X Phlebology (Licence: AK 6365) |
| Enumeration Date | 2006-12-26 |
| Last Update Date | 2023-03-07 |