| NPI | 1508885575 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2086S0105X Surgery, Surgery of the Hand (Licence: AZ 32112) |
| Additional Taxonomies | 208600000X Surgery (Licence: AZ 32112) |
| Enumeration Date | 2006-07-19 |
| Last Update Date | 2017-05-01 |