| NPI | 1306157110 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0127X Surgery Trauma Surgery (Licence: FL ME170440) |
| Additional Taxonomies | 2086S0102X Surgery Surgical Critical Care (Licence: TX S7295) |
| Enumeration Date | 2010-06-25 |
| Last Update Date | 2024-10-07 |