| NPI | 1407436652 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: PA MD492710) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: NJ 25MA12935600) |
| Enumeration Date | 2021-04-12 |
| Last Update Date | 2026-07-31 |