| NPI | 1942591524 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207XS0106X Orthopaedic Surgery, Hand Surgery (Licence: OH 35.127967) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: PA MT 198307) |
| 207X00000X Orthopaedic Surgery (Licence: NC 2014-20543) | |
| Enumeration Date | 2011-04-29 |
| Last Update Date | 2021-03-18 |