| NPI | 1598736720 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: RI MD11112) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: TX M1420) |
| Enumeration Date | 2006-01-27 |
| Last Update Date | 2014-06-20 |