| NPI | 1851552608 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207XS0106X Orthopaedic Surgery Hand Surgery (Licence: NC 2011-0104) |
| Additional Taxonomies | 207XS0106X Orthopaedic Surgery Hand Surgery (Licence: NC 2011-0105) |
| Enumeration Date | 2008-06-24 |
| Last Update Date | 2016-03-31 |