| NPI | 1952698862 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 202K00000X Phlebology (Licence: WA 60850555) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: WA 60850555) |
| Enumeration Date | 2011-06-30 |
| Last Update Date | 2025-02-07 |