| NPI | 1265470389 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: NJ 25MA03504900) |
| Additional Taxonomies | 174400000X Specialist (Licence: NJ 25MA03504900) |
| Enumeration Date | 2006-06-02 |
| Last Update Date | 2016-01-19 |