| NPI | 1578559001 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: NY 218271) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: NJ 25MB10402300) |
| Enumeration Date | 2005-09-20 |
| Last Update Date | 2022-08-26 |