| NPI | 1306152632 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: RI MD16107) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: VA 0101250199) |
| Enumeration Date | 2010-08-24 |
| Last Update Date | 2018-05-25 |