| NPI | 1568698330 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: MA 264776) |
| Additional Taxonomies | 207XS0106X Orthopaedic Surgery, Hand Surgery (Licence: MA 264776) |
| 207X00000X Orthopaedic Surgery (Licence: NH 18191) | |
| Enumeration Date | 2009-06-06 |
| Last Update Date | 2017-07-25 |