| NPI | 1558702498 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: NJ 25MA10613200) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: MO 2018011785) |
| Enumeration Date | 2013-07-08 |
| Last Update Date | 2019-08-07 |