| NPI | 1902893605 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: PA MD041174E) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: NJ 25MA05107600) |
| 207XS0117X Orthopaedic Surgery, Orthopaedic Surgery of the Spine (Licence: NJ 25MA05107600) | |
| Enumeration Date | 2005-09-29 |
| Last Update Date | 2022-04-13 |