| NPI | 1497136907 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: MA 278090) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: WA 61032961) |
| 207XS0106X Orthopaedic Surgery, Hand Surgery (Licence: MA 278090) | |
| Enumeration Date | 2015-06-11 |
| Last Update Date | 2021-06-29 |