| NPI | 1043204985 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: NJ 25MA05143200) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: NY 1548001) |
| 207X00000X Orthopaedic Surgery (Licence: CA G60360) | |
| Enumeration Date | 2005-09-07 |
| Last Update Date | 2023-10-18 |