| NPI | 1215956115 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: FL ME125710) |
| Additional Taxonomies | 208600000X Surgery (Licence: MA 215908) |
| 174400000X Specialist (Licence: FL ME125710) | |
| 2086S0102X Surgery, Surgical Critical Care (Licence: MA 215908) | |
| 2086S0127X Surgery, Trauma Surgery (Licence: FL ME125710) | |
| Enumeration Date | 2006-07-19 |
| Last Update Date | 2022-07-22 |