| NPI | 1518458371 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: CT 81093) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: RI MD19033) |
| Enumeration Date | 2018-05-28 |
| Last Update Date | 2025-06-18 |