| NPI | 1083650758 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: NY 235464) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: NJ 25MA07198) |
| Enumeration Date | 2006-06-21 |
| Last Update Date | 2023-04-04 |