| NPI | 1548757255 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: NY 323260) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: NJ 25MA11853700) |
| Enumeration Date | 2018-04-18 |
| Last Update Date | 2023-05-30 |