| NPI | 1861782997 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: PA MD450892) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: NJ 25MA10253800) |
| 207XS0114X Orthopaedic Surgery, Adult Reconstructive Orthopaedic Surgery (Licence: PA MD450892) | |
| Enumeration Date | 2011-04-11 |
| Last Update Date | 2025-06-27 |