| NPI | 1033317219 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: NJ 25MA07911500) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: NY 246311-1) |
| 207X00000X Orthopaedic Surgery (Licence: CT 045983) | |
| Enumeration Date | 2007-07-10 |
| Last Update Date | 2012-12-11 |