| NPI | 1700104874 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208600000X Surgery (Licence: FL ME 107033) |
| Additional Taxonomies | 2086S0127X Surgery, Trauma Surgery (Licence: FL ME107033) |
| 174400000X Specialist (Licence: FL ME107033) | |
| Enumeration Date | 2010-05-13 |
| Last Update Date | 2025-09-03 |