| NPI | 1508154709 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: NJ 25MA10479200) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: PA MD443413) |
| Enumeration Date | 2011-07-21 |
| Last Update Date | 2023-11-24 |