| NPI | 1730249517 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: PA MD430661) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: FL ME152545) |
| 207X00000X Orthopaedic Surgery (Licence: NJ 25MA08795400) | |
| Enumeration Date | 2006-12-11 |
| Last Update Date | 2022-02-15 |