| NPI | 1942248273 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207XX0005X Orthopaedic Surgery, Sports Medicine (Licence: PA MD-039043-L) |
| Additional Taxonomies | 207XX0005X Orthopaedic Surgery, Sports Medicine (Licence: NJ 25MA04441500) |
| Enumeration Date | 2006-06-02 |
| Last Update Date | 2015-11-10 |