| NPI | 1356723712 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 207XS0106X Orthopaedic Surgery, Hand Surgery (Licence: MI 5101027961) | 
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: MO 2021007077) | 
| Enumeration Date | 2015-06-22 | 
| Last Update Date | 2025-01-31 |