| NPI | 1619263241 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207XS0106X Orthopaedic Surgery, Hand Surgery (Licence: GA 081317) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: MA 269905) |
| 207X00000X Orthopaedic Surgery (Licence: MN 55500) | |
| Enumeration Date | 2011-06-22 |
| Last Update Date | 2018-10-04 |