| NPI | 1154702249 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: NJ 25MA10987700) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: PA MT209693) |
| Enumeration Date | 2015-06-15 |
| Last Update Date | 2021-07-08 |