| NPI | 1093984890 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: NJ 25MA08716300) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: NY 238313) |
| 207X00000X Orthopaedic Surgery (Licence: KY 41753) | |
| Enumeration Date | 2008-02-26 |
| Last Update Date | 2015-09-19 |