| NPI | 1396828901 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: CA A84565) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: NJ 25MA10268700) |
| Enumeration Date | 2006-10-24 |
| Last Update Date | 2025-05-02 |