| NPI | 1629059845 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 202K00000X Phlebology (Licence: AK 7643) |
| Additional Taxonomies | 174400000X Specialist (Licence: MA 39662) |
| Enumeration Date | 2005-11-07 |
| Last Update Date | 2016-10-24 |