| NPI | 1417304411 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: NC 2022-00816) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: RI MD17530) |
| Enumeration Date | 2016-05-19 |
| Last Update Date | 2023-11-17 |