| NPI | 1073938460 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207XS0114X Orthopaedic Surgery, Adult Reconstructive Orthopaedic Surgery (Licence: TX V7651) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: NJ 25MB10797400) |
| 207XS0114X Orthopaedic Surgery, Adult Reconstructive Orthopaedic Surgery (Licence: NJ 25MB10797400) | |
| Enumeration Date | 2014-02-21 |
| Last Update Date | 2026-07-06 |