| NPI | 1992959746 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207XS0106X Orthopaedic Surgery, Hand Surgery (Licence: WA MD 60217611) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: WA MD 60217611) |
| Enumeration Date | 2008-11-06 |
| Last Update Date | 2026-05-27 |