| NPI | 1417175209 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2086S0105X Surgery, Surgery of the Hand (Licence: TX N0228) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: KY 40806) |
| 207XS0106X Orthopaedic Surgery, Hand Surgery (Licence: TX N0228) | |
| 208600000X Surgery (Licence: MI 4301080172) | |
| 2086S0105X Surgery, Surgery of the Hand (Licence: KY 40806) | |
| Enumeration Date | 2007-04-24 |
| Last Update Date | 2019-06-11 |