| NPI | 1679197180 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207XS0106X Orthopaedic Surgery, Hand Surgery (Licence: KY 61230) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: MI 4351045998) |
| 207X00000X Orthopaedic Surgery (Licence: KY 61230) | |
| Enumeration Date | 2020-06-01 |
| Last Update Date | 2026-08-21 |