| NPI | 1992703565 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: PA MD028898E) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: NJ 25MA10253600) |
| 207XX0005X Orthopaedic Surgery, Sports Medicine (Licence: PA MD028898E) | |
| Enumeration Date | 2005-07-08 |
| Last Update Date | 2024-05-21 |