NPI | 1366063703 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: VA 0101286162) |
Additional Taxonomies | 207XS0106X Orthopaedic Surgery, Hand Surgery (Licence: VA 0101286162) |
Enumeration Date | 2020-04-27 |
Last Update Date | 2025-08-11 |