| NPI | 1508960162 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: NY 125682) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: NJ MA5070300) |
| Enumeration Date | 2006-09-12 |
| Last Update Date | 2007-07-08 |