| NPI | 1104812049 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: RI MD09498) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: MA 261934) |
| Enumeration Date | 2005-09-26 |
| Last Update Date | 2025-05-02 |