| NPI | 1427686005 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: NJ 25MA13050200) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: CA A180391) |
| Enumeration Date | 2020-03-30 |
| Last Update Date | 2026-06-12 |