| NPI | 1164408985 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207XS0106X Orthopaedic Surgery, Hand Surgery (Licence: MI SK008923) |
| Additional Taxonomies | 225XH1200X Occupational Therapist, Hand (Licence: MI 989940) |
| Enumeration Date | 2005-12-22 |
| Last Update Date | 2011-08-19 |