| NPI | 1619311263 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: PA MD466322) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: NJ 25MA11182400) |
| Enumeration Date | 2013-04-25 |
| Last Update Date | 2025-10-01 |