| NPI | 1356795082 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207XS0106X Orthopaedic Surgery, Hand Surgery (Licence: NC 202202269) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: RI MD17616) |
| 207X00000X Orthopaedic Surgery (Licence: NC 2022-02269) | |
| Enumeration Date | 2016-04-19 |
| Last Update Date | 2022-10-05 |