| NPI | 1083890883 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207XS0106X Orthopaedic Surgery, Hand Surgery (Licence: OH 35120395) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: OH 57-013092) |
| Enumeration Date | 2008-01-11 |
| Last Update Date | 2021-09-07 |