| NPI | 1083805675 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: RI 14290) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: MO 2007017133) |
| Enumeration Date | 2007-08-07 |
| Last Update Date | 2013-07-25 |