| NPI | 1366405813 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: NJ 25MA07398000) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: PA MD444423) |
| 207XX0005X Orthopaedic Surgery, Sports Medicine (Licence: NJ 207X00000X) | |
| Enumeration Date | 2006-04-07 |
| Last Update Date | 2024-06-10 |