| NPI | 1770273013 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207XS0106X Orthopaedic Surgery, Hand Surgery (Licence: MD C0008935) |
| Additional Taxonomies | 363A00000X Physician Assistant |
| Enumeration Date | 2023-05-10 |
| Last Update Date | 2023-07-19 |