| NPI | 1790746162 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207XS0106X Orthopaedic Surgery, Hand Surgery (Licence: PA MD059555L) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: NY 308173) |
| 207XS0106X Orthopaedic Surgery, Hand Surgery (Licence: NJ 25MA09473400) | |
| 207XS0106X Orthopaedic Surgery, Hand Surgery (Licence: NY 308173) | |
| Enumeration Date | 2006-03-28 |
| Last Update Date | 2021-11-03 |