| NPI | 1184981375 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 2086S0105X Surgery, Surgery of the Hand (Licence: TX R4108) | 
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: TX R4108) | 
| Enumeration Date | 2012-04-12 | 
| Last Update Date | 2025-10-04 |