| NPI | 1932605201 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: CA A197133) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: NJ 25MA12348800) |
| 207X00000X Orthopaedic Surgery (Licence: PA MD486372) | |
| Enumeration Date | 2018-04-04 |
| Last Update Date | 2025-11-13 |