| NPI | 1740683275 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: NJ 25MA09944800) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: PA MD453280) |
| Enumeration Date | 2014-09-29 |
| Last Update Date | 2020-09-17 |