| NPI | 1083857536 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207XS0106X Orthopaedic Surgery, Hand Surgery (Licence: ID O-0574) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: OH 58.001617) |
| Enumeration Date | 2009-04-14 |
| Last Update Date | 2018-03-29 |