| NPI | 1649211772 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 202K00000X Phlebology (Licence: MS 00342) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: MS 13190) |
| Enumeration Date | 2006-06-09 |
| Last Update Date | 2021-01-12 |