| NPI | 1427204106 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: NJ 25MA09267200) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: NY 252444) |
| 207XS0114X Orthopaedic Surgery, Adult Reconstructive Orthopaedic Surgery (Licence: NY 252444) | |
| Enumeration Date | 2008-08-13 |
| Last Update Date | 2024-11-01 |