| NPI | 1396976247 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: PA MD450815) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: NJ 25MA09753900) |
| 207X00000X Orthopaedic Surgery (Licence: PA MT194698) | |
| Enumeration Date | 2009-07-27 |
| Last Update Date | 2020-06-03 |