| NPI | 1447230917 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 202K00000X Phlebology (Licence: NC 000238) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: NC 39393) |
| Enumeration Date | 2006-01-19 |
| Last Update Date | 2018-03-17 |