| NPI | 1619235744 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207XS0106X Orthopaedic Surgery, Hand Surgery (Licence: TX R6218) |
| Additional Taxonomies | 207XS0106X Orthopaedic Surgery, Hand Surgery (Licence: MO 2017004303) |
| 207X00000X Orthopaedic Surgery (Licence: IA R-9390) | |
| Enumeration Date | 2012-04-26 |
| Last Update Date | 2019-12-03 |