| NPI | 1174054746 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207XS0106X Orthopaedic Surgery, Hand Surgery (Licence: WA MD61425454) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: OR MD200356) |
| 207X00000X Orthopaedic Surgery (Licence: RI MD18339) | |
| Enumeration Date | 2017-03-24 |
| Last Update Date | 2023-11-16 |