| NPI | 1548220619 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 202K00000X Phlebology (Licence: NC AP9426772) |
| Additional Taxonomies | 208D00000X General Practice (Licence: NC 24284) |
| Enumeration Date | 2006-03-24 |
| Last Update Date | 2023-10-25 |