| NPI | 1902936016 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207XS0106X Orthopaedic Surgery, Hand Surgery (Licence: FL ME142621) |
| Additional Taxonomies | 208600000X Surgery (Licence: KY 41844) |
| Enumeration Date | 2007-03-07 |
| Last Update Date | 2021-03-31 |