| NPI | 1962846931 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: PA MD491839) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: NJ 25MA12328000) |
| Enumeration Date | 2013-04-22 |
| Last Update Date | 2026-01-21 |