| NPI | 1750919205 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: OH 35.156703) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: RI MD20645) |
| Enumeration Date | 2020-03-31 |
| Last Update Date | 2026-09-04 |