| NPI | 1669829982 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: PA MD480235) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: NJ 25MA11782500) |
| Enumeration Date | 2016-05-17 |
| Last Update Date | 2025-10-27 |