| NPI | 1588771745 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: CA A108023) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: RI LP00167) |
| Enumeration Date | 2006-08-24 |
| Last Update Date | 2023-03-07 |