| NPI | 1275981060 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: NJ 25MA11870100) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: RI MD17668) |
| Enumeration Date | 2016-06-02 |
| Last Update Date | 2023-12-20 |