| NPI | 1902895659 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207XS0106X Orthopaedic Surgery, Hand Surgery (Licence: WI 43075020) |
| Additional Taxonomies | 207XX0005X Orthopaedic Surgery, Sports Medicine (Licence: WI 43075020) |
| Enumeration Date | 2005-10-17 |
| Last Update Date | 2010-08-13 |