| NPI | 1457510844 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207XX0005X Orthopaedic Surgery, Sports Medicine (Licence: NY 267190) |
| Additional Taxonomies | 207XX0005X Orthopaedic Surgery, Sports Medicine (Licence: CA A102934) |
| 207XX0005X Orthopaedic Surgery, Sports Medicine (Licence: NJ 25MA08727600) | |
| Enumeration Date | 2008-06-02 |
| Last Update Date | 2021-04-01 |