| NPI | 1326005307 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207XS0114X Orthopaedic Surgery, Adult Reconstructive Orthopaedic Surgery (Licence: NJ 25MA09165800) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: CA A92330) |
| 207X00000X Orthopaedic Surgery (Licence: GA 52523) | |
| 207XX0005X Orthopaedic Surgery, Sports Medicine (Licence: NY 271409-1) | |
| 207XX0005X Orthopaedic Surgery, Sports Medicine (Licence: NJ 25MA09165800) | |
| Enumeration Date | 2006-04-26 |
| Last Update Date | 2020-12-29 |