| NPI | 1902811656 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: GA 98137) |
| Additional Taxonomies | 202K00000X Phlebology (Licence: GA 98137) |
| 208600000X Surgery (Licence: TN 1300) | |
| 208600000X Surgery (Licence: AL 0480) | |
| Enumeration Date | 2006-07-30 |
| Last Update Date | 2025-02-15 |