| NPI | 1891993572 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207XS0114X Orthopaedic Surgery, Adult Reconstructive Orthopaedic Surgery (Licence: NJ 25MA09989900) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: NJ 25MA09989900) |
| 207X00000X Orthopaedic Surgery (Licence: PA MD438490) | |
| Enumeration Date | 2007-07-05 |
| Last Update Date | 2025-10-03 |