| NPI | 1881855955 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: NJ 25MA09164100) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: PA MT191213) |
| 207XS0106X Orthopaedic Surgery Hand Surgery (Licence: NJ 25MA09164100) | |
| Enumeration Date | 2008-06-21 |
| Last Update Date | 2022-06-20 |