| NPI | 1629463872 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: WI 75730-20) |
| Additional Taxonomies | 207XP3100X Orthopaedic Surgery Pediatric Orthopaedic Surgery (Licence: WI 75730-20) |
| 207XS0106X Orthopaedic Surgery Hand Surgery (Licence: WI 75730-20) | |
| Enumeration Date | 2015-04-04 |
| Last Update Date | 2022-01-10 |