| NPI | 1073510038 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: PA MD044007L) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: FL ME151228) |
| 207X00000X Orthopaedic Surgery (Licence: NJ 25MA04400700) | |
| Enumeration Date | 2005-07-06 |
| Last Update Date | 2021-11-03 |