| NPI | 1760447346 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | |
| Primary Taxonomy | 207XS0106X Orthopaedic Surgery Hand Surgery (Licence: MA 76399) |
| Additional Taxonomies | 207XS0106X Orthopaedic Surgery Hand Surgery (Licence: CT 035130) |
| 207XS0106X Orthopaedic Surgery Hand Surgery (Licence: NJ 25MA05133400) | |
| Enumeration Date | 2006-04-18 |
| Last Update Date | 2007-07-08 |