| NPI | 1477872349 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208600000X Surgery (Licence: FL ME116931) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: FL ME116931) |
| Enumeration Date | 2010-05-18 |
| Last Update Date | 2025-01-22 |