| NPI | 1871688192 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: PA MD022236E) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: NJ 25MA07384300) |
| Enumeration Date | 2006-10-03 |
| Last Update Date | 2014-10-31 |