| NPI | 1205970431 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208C00000X Colon & Rectal Surgery (Licence: FL ME108308) |
| Additional Taxonomies | 208600000X Surgery (Licence: ME MD19555) |
| 208600000X Surgery (Licence: FL ME108308) | |
| 2086S0102X Surgery, Surgical Critical Care (Licence: ME MD19555) | |
| 208C00000X Colon & Rectal Surgery (Licence: ME MD19555) | |
| Enumeration Date | 2007-02-19 |
| Last Update Date | 2022-03-04 |