| NPI | 1053800490 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: PA MD472832) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: NJ 25MA11731200) |
| Enumeration Date | 2018-05-01 |
| Last Update Date | 2023-06-29 |