| NPI | 1174551642 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: PA MD045507L) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: NJ 25MA06166400) |
| 207RS0010X Internal Medicine, Sports Medicine (Licence: PA MD045507L) | |
| Enumeration Date | 2006-06-30 |
| Last Update Date | 2013-04-09 |