| NPI | 1184784001 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: PA MD434656) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: NJ 25MA09113900) |
| Enumeration Date | 2006-12-11 |
| Last Update Date | 2014-10-31 |