| NPI | 1477509529 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 202K00000X Phlebology (Licence: CA A66588) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: CA A66588) |
| 208600000X Surgery (Licence: CA A66588) | |
| 2086S0129X (Licence: CA A66588) | |
| Enumeration Date | 2006-05-26 |
| Last Update Date | 2025-02-25 |