| NPI | 1538729181 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: NC 2025-01656) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: RI MD19992) |
| Enumeration Date | 2019-06-17 |
| Last Update Date | 2025-07-17 |