| NPI | 1760821433 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: NJ 25MA10556200) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: PA MT204663) |
| Enumeration Date | 2013-06-17 |
| Last Update Date | 2019-10-01 |