| NPI | 1588857874 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2086S0105X Surgery, Surgery of the Hand (Licence: TX N5229) |
| Additional Taxonomies | 208600000X Surgery (Licence: PA MT185032) |
| 208600000X Surgery (Licence: PA MT 185032) | |
| Enumeration Date | 2007-08-21 |
| Last Update Date | 2020-09-08 |