| NPI | 1003810045 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: PA OS-007347-E) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: NJ MB55629) |
| Enumeration Date | 2005-06-08 |
| Last Update Date | 2025-10-28 |