| NPI | 1922686641 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207XS0106X Orthopaedic Surgery, Hand Surgery (Licence: WV 32295) |
| Additional Taxonomies | 207XX0005X Orthopaedic Surgery, Sports Medicine (Licence: WV 32295) |
| 207X00000X Orthopaedic Surgery (Licence: WV 32295) | |
| Enumeration Date | 2021-04-01 |
| Last Update Date | 2024-01-05 |