| NPI | 1366900243 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: NJ 25MA12882800) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: TX V1231) |
| Enumeration Date | 2019-03-09 |
| Last Update Date | 2025-10-27 |