| NPI | 1700167814 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207XS0106X Orthopaedic Surgery, Hand Surgery (Licence: TX R6249) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: RI MD15842) |
| Enumeration Date | 2011-09-01 |
| Last Update Date | 2018-07-08 |