| NPI | 1366979163 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: PA MD486400) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: NJ 25MA11922400) |
| Enumeration Date | 2017-05-11 |
| Last Update Date | 2024-09-03 |