| NPI | 1467484923 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: NJ 32659) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: NJ ma03265900) |
| 207X00000X Orthopaedic Surgery (Licence: NY 117102-1) | |
| Enumeration Date | 2006-07-07 |
| Last Update Date | 2011-06-14 |