| NPI | 1699747774 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: PA MD014140E) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: NJ 25MA02335000) |
| Enumeration Date | 2006-02-03 |
| Last Update Date | 2010-08-02 |