| NPI | 1609403146 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 2086S0105X Surgery, Surgery of the Hand (Licence: MN 79964) | 
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: MA NA) | 
| Enumeration Date | 2020-03-25 | 
| Last Update Date | 2025-08-05 |