| NPI | 1679920995 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: VT 042.0017123) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: RI MD17559) |
| 207X00000X Orthopaedic Surgery (Licence: WA MD61260462) | |
| Enumeration Date | 2016-05-17 |
| Last Update Date | 2023-09-20 |