| NPI | 1497847990 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: NJ MA45396) |
| Additional Taxonomies | 207XX0005X Orthopaedic Surgery Sports Medicine (Licence: NJ MA45396) |
| Enumeration Date | 2006-09-29 |
| Last Update Date | 2016-10-04 |