| NPI | 1508800996 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: WA MD00048741) |
| Additional Taxonomies | 174400000X Specialist (Licence: OH 35087107) |
| 207XS0106X Orthopaedic Surgery, Hand Surgery (Licence: WA MD00048741) | |
| Enumeration Date | 2006-06-15 |
| Last Update Date | 2021-03-31 |