| NPI | 1528446572 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 2086S0105X Surgery, Surgery of the Hand (Licence: TX U5988)  | 
| Additional Taxonomies | 208600000X Surgery (Licence: TX BP10052704)  | 
| Enumeration Date | 2015-05-11 | 
| Last Update Date | 2023-09-08 |