| NPI | 1376926709 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: NJ 25MB10998000) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: PA OT016307) |
| Enumeration Date | 2015-07-02 |
| Last Update Date | 2021-07-06 |