| NPI | 1588059935 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: TX T0467) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: TN 61076) |
| 207XS0106X Orthopaedic Surgery, Hand Surgery (Licence: TX T0467) | |
| Enumeration Date | 2015-04-02 |
| Last Update Date | 2026-04-13 |