| NPI | 1992754063 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0129X (Licence: NY 340071) |
| Additional Taxonomies | 2086S0129X (Licence: IL 036177654) |
| 202K00000X Phlebology (Licence: IL 036177654) | |
| 208600000X Surgery (Licence: NJ 25MA05096600) | |
| 202K00000X Phlebology (Licence: NY 340071) | |
| 2086S0129X (Licence: NJ 25MA05096600) | |
| Enumeration Date | 2006-05-08 |
| Last Update Date | 2026-06-24 |