| NPI | 1902874993 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: NJ 25MA53639) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: PA MD445253) |
| Enumeration Date | 2006-03-08 |
| Last Update Date | 2022-03-14 |