| NPI | 1285639898 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: FL ME40957) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: FL ME40957) |
| 2086S0102X Surgery Surgical Critical Care (Licence: FL ME40957) | |
| Enumeration Date | 2005-06-20 |
| Last Update Date | 2016-09-14 |