| NPI | 1679731467 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: VA 0101287380) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: WV 24178) |
| 207XX0005X Orthopaedic Surgery, Sports Medicine (Licence: WV 24178) | |
| 207XS0106X Orthopaedic Surgery, Hand Surgery (Licence: WV 24178) | |
| 207XS0106X Orthopaedic Surgery, Hand Surgery (Licence: VA 0101287380) | |
| Enumeration Date | 2008-05-28 |
| Last Update Date | 2025-12-03 |