| NPI | 1790902104 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: TX P4114) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: FL ME148732) |
| 207XS0106X Orthopaedic Surgery, Hand Surgery (Licence: TX P4114) | |
| Enumeration Date | 2007-04-19 |
| Last Update Date | 2023-01-18 |