| NPI | 1972797124 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207XS0106X Orthopaedic Surgery, Hand Surgery (Licence: LA MD202687) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: FL ME99855) |
| 207X00000X Orthopaedic Surgery (Licence: PA MD432690) | |
| Enumeration Date | 2007-08-30 |
| Last Update Date | 2020-09-01 |