| NPI | 1275115560 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: NY 321046) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: NJ 25MA11781700) |
| 207XX0005X Orthopaedic Surgery, Sports Medicine (Licence: IL 125.077274) | |
| 207XX0005X Orthopaedic Surgery, Sports Medicine (Licence: NY 321046) | |
| Enumeration Date | 2021-04-26 |
| Last Update Date | 2024-05-21 |