| NPI | 1154816122 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: RI MD19054) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: MI 4301115387) |
| Enumeration Date | 2018-06-22 |
| Last Update Date | 2023-07-19 |