| NPI | 1336469170 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: RI 14895) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: RI LP01925) |
| Enumeration Date | 2010-06-03 |
| Last Update Date | 2015-09-16 |