| NPI | 1568432862 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0102X Surgery, Surgical Critical Care (Licence: FL ME112973) |
| Additional Taxonomies | 2086S0127X Surgery, Trauma Surgery (Licence: FL ME112973) |
| Enumeration Date | 2006-01-26 |
| Last Update Date | 2014-08-27 |