| NPI | 1831235928 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 202K00000X Phlebology (Licence: MO MDR6C15) |
| Additional Taxonomies | 208600000X Surgery (Licence: MO MDR6C15) |
| Enumeration Date | 2007-01-29 |
| Last Update Date | 2010-08-19 |