| NPI | 1952367534 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 202K00000X Phlebology (Licence: KS 0428268) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: KS 0428268) |
| Enumeration Date | 2006-04-24 |
| Last Update Date | 2007-07-08 |