| NPI | 1083653398 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: NJ 25MA07233700) |
| Additional Taxonomies | 207XX0005X Orthopaedic Surgery, Sports Medicine (Licence: NY 307189) |
| 207XX0005X Orthopaedic Surgery, Sports Medicine (Licence: PA MD060583L) | |
| 207XX0005X Orthopaedic Surgery, Sports Medicine (Licence: FL ME152455) | |
| Enumeration Date | 2006-06-05 |
| Last Update Date | 2024-07-16 |