| NPI | 1649891250 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: WA MD.MD.70110609) |
| Additional Taxonomies | 207XS0106X Orthopaedic Surgery, Hand Surgery (Licence: WA MD.MD.70110609) |
| Enumeration Date | 2020-05-05 |
| Last Update Date | 2026-10-01 |