| NPI | 1508859935 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: NJ 25MA04325000) |
| Additional Taxonomies | 174400000X Specialist (Licence: NJ 25MA04325000) |
| Enumeration Date | 2005-08-31 |
| Last Update Date | 2016-11-29 |