| NPI | 1871578351 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: NJ 25MA08880000) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: MA 224394) |
| 207X00000X Orthopaedic Surgery (Licence: PA MD439553) | |
| Enumeration Date | 2005-12-07 |
| Last Update Date | 2023-01-12 |