| NPI | 1659349363 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: NJ 25MA06999100) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: NY 213845-1) |
| 207X00000X Orthopaedic Surgery (Licence: PA MD068759L) | |
| Enumeration Date | 2006-03-09 |
| Last Update Date | 2007-11-27 |