| NPI | 1598083438 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207XP3100X Orthopaedic Surgery, Pediatric Orthopaedic Surgery (Licence: NJ 25MA10257200) |
| Additional Taxonomies | 207XP3100X Orthopaedic Surgery, Pediatric Orthopaedic Surgery (Licence: FL ME128463) |
| Enumeration Date | 2010-05-16 |
| Last Update Date | 2018-02-12 |