| NPI | 1912160748 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207XS0106X Orthopaedic Surgery, Hand Surgery (Licence: LA 326146) |
| Additional Taxonomies | 207XS0106X Orthopaedic Surgery, Hand Surgery (Licence: WI 60811-20) |
| 208600000X Surgery (Licence: CO 2901) | |
| Enumeration Date | 2008-07-02 |
| Last Update Date | 2021-08-04 |