| NPI | 1215591953 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: UT 13882190-1205) |
| Additional Taxonomies | 207XS0106X Orthopaedic Surgery, Hand Surgery (Licence: UT 13882190-1205) |
| Enumeration Date | 2019-04-29 |
| Last Update Date | 2024-04-25 |