| NPI | 1285260174 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: PA MD488836) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: NJ 25MA12556900) |
| Enumeration Date | 2020-03-23 |
| Last Update Date | 2025-08-01 |