| NPI | 1801869821 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 202K00000X Phlebology (Licence: NY 1828031) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: NY 1828031) |
| Enumeration Date | 2006-02-09 |
| Last Update Date | 2023-10-26 |