| NPI | 1689134215 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: PA MD489830) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: NJ 25MA12746200) |
| Enumeration Date | 2019-03-20 |
| Last Update Date | 2025-09-17 |