NPI | 1255769519 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 207XX0005X Orthopaedic Surgery, Sports Medicine (Licence: NY 152385-1) |
Additional Taxonomies | 207XX0005X Orthopaedic Surgery, Sports Medicine (Licence: NJ 25MA09367300) |
Enumeration Date | 2013-10-24 |
Last Update Date | 2013-10-24 |