| NPI | 1912351222 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207XS0106X Orthopaedic Surgery, Hand Surgery (Licence: NY 309979-01) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: NY 309979-01) |
| Enumeration Date | 2016-04-22 |
| Last Update Date | 2023-08-15 |