| NPI | 1114995826 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: NJ 25MA05335200) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: PA MD029489E) |
| Enumeration Date | 2006-03-09 |
| Last Update Date | 2019-05-13 |