| NPI | 1609013036 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 2086S0105X Surgery, Surgery of the Hand (Licence: GA 72644) | 
| Additional Taxonomies | 2086S0105X Surgery, Surgery of the Hand (Licence: CT 050410) | 
| 2086S0105X Surgery, Surgery of the Hand (Licence: NY 258302-1) | |
| Enumeration Date | 2009-01-07 | 
| Last Update Date | 2025-06-18 |