| NPI | 1689627507 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207XS0114X Orthopaedic Surgery, Adult Reconstructive Orthopaedic Surgery (Licence: WI 36166) |
| Additional Taxonomies | 208600000X Surgery (Licence: WI 36166) |
| 207QA0401X Family Medicine, Addiction Medicine (Licence: WI 36166) | |
| 207XS0106X Orthopaedic Surgery, Hand Surgery (Licence: WI 36166 Hand Surgery) | |
| Enumeration Date | 2006-05-19 |
| Last Update Date | 2016-07-21 |