| NPI | 1912935479 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: PA MD038220E) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: NJ 25MA02002200) |
| Enumeration Date | 2006-06-30 |
| Last Update Date | 2024-04-20 |