| NPI | 1881893741 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208C00000X Colon & Rectal Surgery (Licence: FL ME140999) |
| Additional Taxonomies | 208600000X Surgery (Licence: SC 38018) |
| 208C00000X Colon & Rectal Surgery (Licence: SC 38018) | |
| 208D00000X General Practice (Licence: FL ME140999) | |
| Enumeration Date | 2007-07-12 |
| Last Update Date | 2023-02-01 |