| NPI | 1619182276 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: NJ 25ma08414800) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: NY 243802) |
| Enumeration Date | 2007-05-14 |
| Last Update Date | 2016-05-31 |