| NPI | 1376510248 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: NJ 25ma06628400) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: CT 67211) |
| Enumeration Date | 2006-03-01 |
| Last Update Date | 2023-04-11 |