| NPI | 1629480959 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: NJ 25MA10855500) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: NY 286682) |
| 207XX0005X Orthopaedic Surgery, Sports Medicine (Licence: NY 286682) | |
| 207XX0005X Orthopaedic Surgery, Sports Medicine (Licence: NJ 25MA10855500) | |
| Enumeration Date | 2014-05-21 |
| Last Update Date | 2023-03-07 |