| NPI | 1891882411 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: FL ME107923) |
| Additional Taxonomies | 2086S0102X Surgery, Surgical Critical Care (Licence: PA MD071121L) |
| Enumeration Date | 2006-10-06 |
| Last Update Date | 2010-12-02 |