| NPI | 1881687747 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0129X (Licence: FL ME94121) |
| Additional Taxonomies | 207PE0005X Emergency Medicine, Undersea and Hyperbaric Medicine (Licence: FL ME94121) |
| 208600000X Surgery (Licence: FL ME94121) | |
| Enumeration Date | 2005-08-25 |
| Last Update Date | 2020-04-24 |