| NPI | 1306890512 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: NJ 25MA08019000) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: PA MD424323) |
| Enumeration Date | 2006-05-20 |
| Last Update Date | 2021-12-10 |