| NPI | 1104089895 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: PA MD446325) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: NJ 25MA09128300) |
| Enumeration Date | 2008-07-03 |
| Last Update Date | 2022-05-18 |