| NPI | 1659783579 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: WA 61149478) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: RI MD16686) |
| 207X00000X Orthopaedic Surgery (Licence: MA 282401) | |
| 207XS0106X Orthopaedic Surgery, Hand Surgery (Licence: WA 61149478) | |
| Enumeration Date | 2014-05-27 |
| Last Update Date | 2021-08-10 |