| NPI | 1508396276 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: NJ 25MA11855900) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: NY 322575) |
| 207XS0114X Orthopaedic Surgery, Adult Reconstructive Orthopaedic Surgery (Licence: NY 322575) | |
| Enumeration Date | 2017-06-15 |
| Last Update Date | 2024-05-21 |