| NPI | 1013904416 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207XS0114X Orthopaedic Surgery, Adult Reconstructive Orthopaedic Surgery (Licence: PA MD417271) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: PA MD417271) |
| 207X00000X Orthopaedic Surgery (Licence: NJ 25MA06677300) | |
| Enumeration Date | 2005-09-30 |
| Last Update Date | 2024-08-20 |