| NPI | 1992328025 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: NC 2026-02883) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: RI MD20611) |
| Enumeration Date | 2020-05-23 |
| Last Update Date | 2026-07-09 |