| NPI | 1457347395 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207XX0005X Orthopaedic Surgery, Sports Medicine (Licence: RI MD11020) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: CT 053636) |
| Enumeration Date | 2005-09-26 |
| Last Update Date | 2015-11-20 |