| NPI | 1013954262 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207XX0005X Orthopaedic Surgery, Sports Medicine (Licence: NJ 25MA05859400) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: NJ 25MA05859400) |
| 207XX0005X Orthopaedic Surgery, Sports Medicine (Licence: PA MD039877E) | |
| Enumeration Date | 2006-05-31 |
| Last Update Date | 2024-04-26 |