| NPI | 1497782700 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: FL ME151732) |
| Additional Taxonomies | 207N00000X Dermatology (Licence: FL ME151732) |
| 2086S0129X Surgery Vascular Surgery (Licence: FL ME151732) | |
| Enumeration Date | 2006-06-26 |
| Last Update Date | 2023-05-08 |