| NPI | 1184246001 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208600000X Surgery (Licence: RI LP04825) |
| Additional Taxonomies | 2086S0127X Surgery, Trauma Surgery (Licence: MD D0103946) |
| Enumeration Date | 2020-05-13 |
| Last Update Date | 2025-07-03 |