| NPI | 1245287556 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: PA MD040661E) |
| Additional Taxonomies | 207XX0005X Orthopaedic Surgery, Sports Medicine (Licence: PA MD040661E) |
| 207XX0005X Orthopaedic Surgery, Sports Medicine (Licence: NJ 25MA06744600) | |
| Enumeration Date | 2006-05-30 |
| Last Update Date | 2024-07-10 |