| NPI | 1215936992 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207XS0106X Orthopaedic Surgery Hand Surgery (Licence: CT 039385) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: CT 039385) |
| 207XX0005X Orthopaedic Surgery Sports Medicine (Licence: CT 039385) | |
| Enumeration Date | 2005-07-15 |
| Last Update Date | 2018-08-28 |