| NPI | 1952698862 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 202K00000X Phlebology (Licence: TX Q2843) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: TX Q2843) |
| Enumeration Date | 2011-06-30 |
| Last Update Date | 2022-01-20 |