| NPI | 1821301409 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: FL OS14066) |
| Additional Taxonomies | 202K00000X Phlebology (Licence: FL OS14066) |
| Enumeration Date | 2010-07-23 |
| Last Update Date | 2025-02-15 |