| NPI | 1952483505 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 202K00000X Phlebology (Licence: CT 72835) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: NY 216423-1) |
| Enumeration Date | 2006-10-20 |
| Last Update Date | 2026-06-29 |