| NPI | 1962461426 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0129X Surgery, Vascular Surgery (Licence: GA 011644) |
| Additional Taxonomies | 202K00000X Phlebology (Licence: GA 011644) |
| Enumeration Date | 2006-03-22 |
| Last Update Date | 2010-08-05 |