| NPI | 1679954812 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207XS0106X Orthopaedic Surgery, Hand Surgery (Licence: NC 2024-00843) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: PA MT211670) |
| 207X00000X Orthopaedic Surgery (Licence: IA MD-50446) | |
| 208600000X Surgery (Licence: IL 125066673) | |
| Enumeration Date | 2015-06-13 |
| Last Update Date | 2024-08-01 |