| NPI | 1083713853 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: NJ MA025939) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: NJ 25MA02593900) |
| Enumeration Date | 2006-09-21 |
| Last Update Date | 2010-04-28 |