Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2086S0105X | Surgery of the Hand | 62891 | GA |
NPI | 1962680991 |
---|---|
Provider Name | Daniel Judah Holtz |
First Address | Acworth, GA 30101-4180 |
Second Address | Acworth, GA 30101-4180 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 01/02/2008 |
Last Update Date | 30/10/2019 |