| NPI | 1164765731 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0102X Surgery, Surgical Critical Care (Licence: FL ME137915) |
| Additional Taxonomies | 2086S0127X Surgery, Trauma Surgery (Licence: FL ME137915) |
| 208600000X Surgery (Licence: FL ME137915) | |
| Enumeration Date | 2013-04-02 |
| Last Update Date | 2026-05-08 |