| NPI | 1962851147 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: PA MD479082) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: NJ 25MA11519900) |
| Enumeration Date | 2016-06-08 |
| Last Update Date | 2024-05-16 |