| NPI | 1144340183 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 2086S0105X Surgery, Surgery of the Hand (Licence: VA 101247549)  | 
| Additional Taxonomies | 208600000X Surgery (Licence: NY 239250)  | 
| 208600000X Surgery (Licence: VA 0101247549)  | |
| Enumeration Date | 2007-03-31 | 
| Last Update Date | 2017-10-23 |