| NPI | 1992906432 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: FL ME98852) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: FL ME98852) |
| Enumeration Date | 2007-05-31 |
| Last Update Date | 2023-12-14 |