| NPI | 1346227428 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: NJ MA069963) |
| Additional Taxonomies | 207XX0004X Orthopaedic Surgery, Foot and Ankle Surgery (Licence: NJ 25MA06996300) |
| Enumeration Date | 2005-12-29 |
| Last Update Date | 2017-12-04 |