| NPI | 1851369979 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: NJ 25ma07977600) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: PA MD020978E) |
| 207X00000X Orthopaedic Surgery (Licence: NY 246151-1) | |
| Enumeration Date | 2006-03-14 |
| Last Update Date | 2014-04-14 |