| NPI | 1588644405 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: NJ 25MA08073500) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: MA 223599) |
| Enumeration Date | 2006-01-18 |
| Last Update Date | 2026-05-19 |