| NPI | 1619073368 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: NY 213911-1) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: NJ 25MA08643900) |
| Enumeration Date | 2006-09-16 |
| Last Update Date | 2025-02-11 |