| NPI | 1033314042 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207XS0114X Orthopaedic Surgery, Adult Reconstructive Orthopaedic Surgery (Licence: NJ 25MA08236500) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: FL ME118641) |
| Enumeration Date | 2007-06-19 |
| Last Update Date | 2018-06-12 |