| NPI | 1821476607 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: RI MD17090) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: NC 2022-00742) |
| Enumeration Date | 2015-05-12 |
| Last Update Date | 2024-02-28 |