| NPI | 1790729903 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: PA OSO12513) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: NJ 25MB11853500) |
| 207XX0801X Orthopaedic Surgery, Orthopaedic Trauma (Licence: NJ 25MB11853500) | |
| 207XX0801X Orthopaedic Surgery, Orthopaedic Trauma (Licence: PA OSO12513) | |
| Enumeration Date | 2006-06-16 |
| Last Update Date | 2024-05-10 |