| NPI | 1912946096 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 202K00000X Phlebology (Licence: NC 00483) |
| Additional Taxonomies | 174400000X Specialist (Licence: CA A40288) |
| 174400000X Specialist (Licence: NC 186439) | |
| 2086S0129X Surgery, Vascular Surgery (Licence: NC 186439) | |
| Enumeration Date | 2006-06-05 |
| Last Update Date | 2014-06-17 |