| NPI | 1356845366 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207XS0114X Orthopaedic Surgery Adult Reconstructive Orthopaedic Surgery (Licence: NJ 25MA12296200) |
| Additional Taxonomies | 207XS0114X Orthopaedic Surgery Adult Reconstructive Orthopaedic Surgery (Licence: NY 321506) |
| Enumeration Date | 2018-03-23 |
| Last Update Date | 2024-08-02 |