| NPI | 1407952310 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2086S0105X Surgery, Surgery of the Hand (Licence: NY 148203) |
| Additional Taxonomies | 174400000X Specialist (Licence: NY 148203) |
| Enumeration Date | 2006-09-16 |
| Last Update Date | 2020-02-21 |