| NPI | 1063807196 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: NJ 25MA12246100) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: GA 84799) |
| Enumeration Date | 2015-04-06 |
| Last Update Date | 2024-07-12 |