| NPI | 1033601968 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: RI MD19057) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: NH 32149) |
| Enumeration Date | 2018-06-06 |
| Last Update Date | 2024-06-11 |