| NPI | 1790986966 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: NJ 25MA10230800) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: PA MT190776) |
| Enumeration Date | 2007-05-29 |
| Last Update Date | 2025-02-19 |