| NPI | 1750584371 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: OH 35.131531) |
| Additional Taxonomies | 207XS0106X Orthopaedic Surgery Hand Surgery (Licence: WA MD60096140) |
| Enumeration Date | 2007-06-10 |
| Last Update Date | 2018-01-09 |