| NPI | 1396052130 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207XX0005X Orthopaedic Surgery, Sports Medicine (Licence: PA MD454672) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: NJ 25MA09149400) |
| 207X00000X Orthopaedic Surgery (Licence: PA MD454672) | |
| 207XX0005X Orthopaedic Surgery, Sports Medicine (Licence: TX P9396) | |
| Enumeration Date | 2010-08-31 |
| Last Update Date | 2024-08-20 |