| NPI | 1770721912 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: FL ME113098) |
| Additional Taxonomies | 202K00000X Phlebology (Licence: FL ME113098) |
| Enumeration Date | 2009-01-26 |
| Last Update Date | 2026-06-30 |