| NPI | 1538197090 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: NJ 25MA09110900) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: PA MD021140E) |
| Enumeration Date | 2006-06-30 |
| Last Update Date | 2018-01-09 |