| NPI | 1740274018 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 2086S0105X Surgery, Surgery of the Hand (Licence: KY 36097)  | 
| Additional Taxonomies | 2086S0105X Surgery, Surgery of the Hand (Licence: IN 01059565A)  | 
| Enumeration Date | 2005-09-01 | 
| Last Update Date | 2016-09-28 |