| NPI | 1952698896 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: NJ 25MA10884600) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: PA MD468019) |
| Enumeration Date | 2011-06-29 |
| Last Update Date | 2026-06-05 |