| NPI | 1457848467 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207XS0106X Orthopaedic Surgery, Hand Surgery (Licence: NC 2023-03057) |
| Additional Taxonomies | 207XS0106X Orthopaedic Surgery, Hand Surgery (Licence: VA 0101279700) |
| 207X00000X Orthopaedic Surgery (Licence: TX T2146) | |
| Enumeration Date | 2018-04-16 |
| Last Update Date | 2025-07-30 |