| NPI | 1093972804 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0102X Surgery, Surgical Critical Care (Licence: FL ME115061) |
| Additional Taxonomies | 208600000X Surgery (Licence: FL TRN12464) |
| 208600000X Surgery (Licence: FL ME115061) | |
| 2086S0127X Surgery, Trauma Surgery (Licence: FL ME115061) | |
| Enumeration Date | 2008-05-20 |
| Last Update Date | 2020-05-06 |