| NPI | 1003296328 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: FL ME151488) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: FL TRN21696) |
| 207XS0106X Orthopaedic Surgery, Hand Surgery (Licence: CA FB9632781) | |
| Enumeration Date | 2015-06-02 |
| Last Update Date | 2021-08-31 |