| 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 |