| NPI | 1669546834 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: NJ 25MA05473100) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: PA MD442362) |
| Enumeration Date | 2006-11-20 |
| Last Update Date | 2019-09-30 |