| NPI | 1598999609 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 202K00000X Phlebology (Licence: AZ 00774) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: AZ 41014) |
| Enumeration Date | 2009-05-05 |
| Last Update Date | 2021-09-27 |