| NPI | 1356338115 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 202K00000X Phlebology (Licence: SC 17611) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: SC 17611) |
| Enumeration Date | 2005-10-05 |
| Last Update Date | 2022-06-23 |