| NPI | 1346879533 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: NJ 25MA12522200) |
| Additional Taxonomies | 207XS0114X Orthopaedic Surgery, Adult Reconstructive Orthopaedic Surgery (Licence: PA MD487914) |
| 207X00000X Orthopaedic Surgery (Licence: PA MD487914) | |
| Enumeration Date | 2020-04-08 |
| Last Update Date | 2025-10-10 |