| NPI | 1316902513 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: NJ 25MA07245100) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: PA MD072441L) |
| 207X00000X Orthopaedic Surgery (Licence: NY 191701) | |
| Enumeration Date | 2006-04-19 |
| Last Update Date | 2022-03-14 |