| NPI | 1194829762 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: PA MD444984) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: NJ 25MA06231800) |
| 207X00000X Orthopaedic Surgery (Licence: NY 303526) | |
| Enumeration Date | 2006-09-12 |
| Last Update Date | 2022-02-21 |