| NPI | 1407385586 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: LA 338003) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: TX 667401) |
| 207XS0106X Orthopaedic Surgery, Hand Surgery (Licence: LA 338003) | |
| Enumeration Date | 2017-06-12 |
| Last Update Date | 2025-09-09 |