| NPI | 1891724076 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: NY 270411) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: PA MD024230E) |
| 207X00000X Orthopaedic Surgery (Licence: NJ 25MA04816000) | |
| Enumeration Date | 2006-07-01 |
| Last Update Date | 2018-12-11 |