| NPI | 1154327146 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: NJ 25MA06569400) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: PA MD061851L) |
| 207X00000X Orthopaedic Surgery (Licence: FL ME152794) | |
| Enumeration Date | 2005-06-23 |
| Last Update Date | 2022-03-14 |