| NPI | 1841360500 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: TX N1100) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: RI LP00474) |
| Enumeration Date | 2006-11-09 |
| Last Update Date | 2021-07-06 |