| NPI | 1396943619 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207XX0005X Orthopaedic Surgery, Sports Medicine (Licence: NJ 25MA08048700) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: PA MD432957) |
| 207X00000X Orthopaedic Surgery (Licence: NJ 25MA08048700) | |
| Enumeration Date | 2007-07-08 |
| Last Update Date | 2026-05-20 |