| NPI | 1306338397 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: CA A194916) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: RI MD19055) |
| Enumeration Date | 2018-06-05 |
| Last Update Date | 2024-06-05 |