| NPI | 1669530630 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086X0206X Surgery, Surgical Oncology (Licence: NE 25264) |
| Additional Taxonomies | 2086X0206X Surgery, Surgical Oncology (Licence: FL ME103180) |
| 207P00000X Emergency Medicine (Licence: FL ME103180) | |
| Enumeration Date | 2006-12-04 |
| Last Update Date | 2016-05-05 |