| NPI | 1063417905 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: NJ 25MA04683900) |
| Additional Taxonomies | 207XX0004X Orthopaedic Surgery, Foot and Ankle Surgery (Licence: NJ 25MA04683900) |
| 207XX0801X Orthopaedic Surgery, Orthopaedic Trauma (Licence: NJ 25MA04683900) | |
| Enumeration Date | 2005-06-16 |
| Last Update Date | 2020-06-15 |