| NPI | 1063644110 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: NY 254443) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: CT 55926) |
| 207XS0106X Orthopaedic Surgery, Hand Surgery (Licence: NY 254443) | |
| Enumeration Date | 2009-08-21 |
| Last Update Date | 2019-02-07 |