| NPI | 1245297399 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: NJ 25MB07902600) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: PA OS005285L) |
| 207X00000X Orthopaedic Surgery (Licence: TX H3598) | |
| Enumeration Date | 2006-05-01 |
| Last Update Date | 2014-03-25 |