| NPI | 1669571758 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: PA MD423680) |
| Additional Taxonomies | 174400000X Specialist (Licence: PA md423680) |
| 207X00000X Orthopaedic Surgery (Licence: NJ 25MA07009000) | |
| Enumeration Date | 2006-09-22 |
| Last Update Date | 2022-03-07 |