| NPI | 1699725952 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 2086S0105X Surgery, Surgery of the Hand (Licence: SC 10481) | 
| Additional Taxonomies | 207XS0106X Orthopaedic Surgery, Hand Surgery (Licence: SC 10481) | 
| 2086S0105X Surgery, Surgery of the Hand (Licence: WA MD61280339) | |
| Enumeration Date | 2006-05-10 | 
| Last Update Date | 2022-03-24 |