| NPI | 1568692051 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207XX0005X Orthopaedic Surgery, Sports Medicine (Licence: NJ 25MA10078400) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: NY 288832) |
| 207XX0005X Orthopaedic Surgery, Sports Medicine (Licence: NY 288832) | |
| 207XX0005X Orthopaedic Surgery, Sports Medicine (Licence: IL 036140594) | |
| 208600000X Surgery (Licence: PR 12348I) | |
| Enumeration Date | 2009-07-20 |
| Last Update Date | 2020-02-20 |