| NPI | 1225060015 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: NE 19446) |
| Additional Taxonomies | 207XX0005X Orthopaedic Surgery Sports Medicine (Licence: NE 19446) |
| 207XS0106X Orthopaedic Surgery Hand Surgery (Licence: NE 19446) | |
| Enumeration Date | 2006-07-06 |
| Last Update Date | 2021-02-25 |