| NPI | 1255711370 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: RI MD17113) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: IL 125.066979) |
| Enumeration Date | 2015-06-03 |
| Last Update Date | 2021-06-25 |