| NPI | 1700813888 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0102X Surgery, Surgical Critical Care (Licence: MA 203147) |
| Additional Taxonomies | 2086S0102X Surgery, Surgical Critical Care (Licence: ME MD22137) |
| 2086S0127X Surgery, Trauma Surgery (Licence: MA 203147) | |
| 2086S0102X Surgery, Surgical Critical Care (Licence: NH 18973) | |
| 2086S0127X Surgery, Trauma Surgery (Licence: ME MD22137) | |
| Enumeration Date | 2006-06-26 |
| Last Update Date | 2026-05-06 |