| NPI | 1700846789 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: GA 110068) |
| Additional Taxonomies | 208600000X Surgery (Licence: FL ME00068562) |
| 202K00000X Phlebology (Licence: GA 110068) | |
| Enumeration Date | 2006-03-24 |
| Last Update Date | 2026-03-26 |