| NPI | 1497300057 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 207XS0106X Orthopaedic Surgery, Hand Surgery (Licence: TX 48827) | 
| Additional Taxonomies | 207XS0106X Orthopaedic Surgery, Hand Surgery (Licence: KY FT598) | 
| 207X00000X Orthopaedic Surgery (Licence: NY 320772) | |
| Enumeration Date | 2019-08-09 | 
| Last Update Date | 2025-08-26 |