NPI | 1346667342 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: NJ 25MP00329000) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: PA MA056670) |
Enumeration Date | 2014-03-27 |
Last Update Date | 2024-09-17 |