| NPI | 1619961976 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: TN MD26680) |
| Additional Taxonomies | 208100000X Physical Medicine & Rehabilitation (Licence: TN MD26680) |
| 2086S0105X Surgery, Surgery of the Hand (Licence: TN MD26680) | |
| Enumeration Date | 2005-09-01 |
| Last Update Date | 2011-04-07 |