| NPI | 1588601488 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: PA MD420057) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: NJ 25MA11596400) |
| 207X00000X Orthopaedic Surgery (Licence: NC 200600545) | |
| Enumeration Date | 2006-05-31 |
| Last Update Date | 2024-05-13 |