| NPI | 1811915747 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 202K00000X Phlebology (Licence: FL OS4153) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: FL OS4153) |
| Enumeration Date | 2006-07-18 |
| Last Update Date | 2010-04-21 |