NPI | 1043532377 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 2086X0206X Surgery, Surgical Oncology (Licence: FL ME133482) |
Additional Taxonomies | 208600000X Surgery (Licence: NY 266149) |
208600000X Surgery (Licence: FL ME133482) | |
282N00000X General Acute Care Hospital | |
Enumeration Date | 2010-03-01 |
Last Update Date | 2022-07-21 |