| NPI | 1073501284 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: NJ 25MA06372200) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: PA MD055981L) |
| Enumeration Date | 2005-10-11 |
| Last Update Date | 2023-11-20 |