| NPI | 1194983676 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0102X Surgery, Surgical Critical Care (Licence: FL ME132861) |
| Additional Taxonomies | 208600000X Surgery (Licence: FL ME132861) |
| 208600000X Surgery (Licence: NC 149242) | |
| Enumeration Date | 2008-05-30 |
| Last Update Date | 2023-04-19 |