| NPI | 1114982865 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: NY 182650) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: WI 45834) |
| 207XS0106X Orthopaedic Surgery, Hand Surgery (Licence: NY 182650) | |
| Enumeration Date | 2006-04-18 |
| Last Update Date | 2014-07-23 |