| NPI | 1144532698 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: NY 278481) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: NJ 25MA09896700) |
| 207XS0114X Orthopaedic Surgery, Adult Reconstructive Orthopaedic Surgery (Licence: NJ 25MA09896700) | |
| Enumeration Date | 2010-07-12 |
| Last Update Date | 2021-04-20 |