| NPI | 1962604306 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: PA MD433901) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: CA A107546) |
| 207X00000X Orthopaedic Surgery (Licence: NJ 25MA09452900) | |
| 207X00000X Orthopaedic Surgery (Licence: NY 302962) | |
| Enumeration Date | 2007-06-05 |
| Last Update Date | 2022-02-23 |