| NPI | 1376571877 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: PA MD047852L) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: FL ME152867) |
| 207X00000X Orthopaedic Surgery (Licence: NY 303210) | |
| 207X00000X Orthopaedic Surgery (Licence: NJ 25MA06457900) | |
| Enumeration Date | 2006-06-30 |
| Last Update Date | 2022-02-25 |