| NPI | 1164411377 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207XS0106X Orthopaedic Surgery, Hand Surgery (Licence: WA MD00038135) |
| Additional Taxonomies | 174400000X Specialist (Licence: CO 34429) |
| Enumeration Date | 2005-10-19 |
| Last Update Date | 2021-04-09 |