| NPI | 1861887440 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: RI MD17114) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: MI 4301117221) |
| 207X00000X Orthopaedic Surgery (Licence: MN 69617) | |
| Enumeration Date | 2015-04-01 |
| Last Update Date | 2022-11-29 |