| NPI | 1316960552 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207XX0801X Orthopaedic Surgery, Orthopaedic Trauma (Licence: NY 201792-1) |
| Additional Taxonomies | 207XX0801X Orthopaedic Surgery, Orthopaedic Trauma (Licence: NJ 25MA07119800) |
| 174400000X Specialist (Licence: NY 201792-1) | |
| Enumeration Date | 2006-07-26 |
| Last Update Date | 2018-05-14 |