| NPI | 1063603454 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: CO 1014) |
| Additional Taxonomies | 207XS0106X Orthopaedic Surgery Hand Surgery (Licence: CO 1014) |
| 207XX0801X Orthopaedic Surgery Orthopaedic Trauma (Licence: CO 1014) | |
| Enumeration Date | 2007-08-09 |
| Last Update Date | 2021-03-10 |