| NPI | 1265460240 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: PA MD426165) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: TN MD40856) |
| 207X00000X Orthopaedic Surgery (Licence: NJ 25MA09013300) | |
| Enumeration Date | 2006-06-29 |
| Last Update Date | 2012-04-24 |