| NPI | 1962583963 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: MA 249422) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: RI MD11748) |
| Enumeration Date | 2006-10-17 |
| Last Update Date | 2021-03-29 |