| NPI | 1003934530 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: NJ 25MA09050800) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: FL ME152746) |
| 207X00000X Orthopaedic Surgery (Licence: NY 281199) | |
| 207X00000X Orthopaedic Surgery (Licence: PA MT188175) | |
| Enumeration Date | 2007-03-26 |
| Last Update Date | 2022-03-14 |