| NPI | 1952357626 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208600000X Surgery (Licence: FL ME85650) |
| Additional Taxonomies | 2085R0204X Radiology, Vascular & Interventional Radiology (Licence: FL ME 85650) |
| 2086S0102X Surgery, Surgical Critical Care (Licence: FL ME 85650) | |
| 2086S0127X Surgery, Trauma Surgery (Licence: FL ME 85650) | |
| 2086S0129X (Licence: FL ME 85650) | |
| 2086X0206X Surgery, Surgical Oncology (Licence: FL ME 85650) | |
| 208C00000X Colon & Rectal Surgery (Licence: FL ME 85650) | |
| 208G00000X Thoracic Surgery (Cardiothoracic Vascular Surgery) (Licence: FL ME 85650) | |
| Enumeration Date | 2006-05-25 |
| Last Update Date | 2016-04-19 |