| NPI | 1710449749 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207XS0106X Orthopaedic Surgery, Hand Surgery (Licence: NM MD2025-0525) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: MA 1018733) |
| Enumeration Date | 2019-03-31 |
| Last Update Date | 2025-09-21 |