| NPI | 1003481615 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207XS0106X Orthopaedic Surgery Hand Surgery (Licence: KY TP117) |
| Additional Taxonomies | 2086S0105X Surgery Surgery of the Hand (Licence: KY FT001) |
| Enumeration Date | 2021-05-25 |
| Last Update Date | 2024-05-23 |