| NPI | 1386733673 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: NJ 25MB07479400) |
| Additional Taxonomies | 207QS0010X Family Medicine, Sports Medicine (Licence: NJ MB074794) |
| Enumeration Date | 2006-10-12 |
| Last Update Date | 2017-04-11 |