| NPI | 1609262039 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207XP3100X Orthopaedic Surgery, Pediatric Orthopaedic Surgery (Licence: NJ 25MB11003500) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: MD H88913) |
| Enumeration Date | 2015-04-13 |
| Last Update Date | 2021-09-03 |