| NPI | 1386886836 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: NJ 25MA09752200) |
| Additional Taxonomies | 207XS0114X Orthopaedic Surgery, Adult Reconstructive Orthopaedic Surgery (Licence: NJ 25MA09752200) |
| Enumeration Date | 2009-03-30 |
| Last Update Date | 2020-09-30 |