| NPI | 1326509589 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207XS0106X Orthopaedic Surgery, Hand Surgery (Licence: UT 14211165-1205) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: RI MD20122) |
| Enumeration Date | 2019-03-28 |
| Last Update Date | 2025-08-04 |