| NPI | 1417186156 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: PA MD461603) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: NJ 25MA09735500) |
| 207X00000X Orthopaedic Surgery (Licence: IL 125055915) | |
| Enumeration Date | 2009-07-02 |
| Last Update Date | 2022-07-21 |