| NPI | 1629195532 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: PA MD432031) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: NJ 25MA08754500) |
| Enumeration Date | 2007-03-24 |
| Last Update Date | 2015-11-10 |