| NPI | 1578905055 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207XX0801X Orthopaedic Surgery, Orthopaedic Trauma (Licence: LA 312387) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: PA MT205157) |
| 207X00000X Orthopaedic Surgery (Licence: NJ 25MA10309700) | |
| Enumeration Date | 2013-07-24 |
| Last Update Date | 2022-12-23 |