| NPI | 1609031715 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: PA OS 014007) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: NJ 25MB08995200) |
| Enumeration Date | 2008-07-29 |
| Last Update Date | 2024-05-22 |