| NPI | 1699932137 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: NJ 25MA09721000) |
| Additional Taxonomies | 208600000X Surgery (Licence: PA MT193238) |
| Enumeration Date | 2008-05-21 |
| Last Update Date | 2017-10-03 |