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 |