| NPI | 1639337884 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207XX0801X Orthopaedic Surgery, Orthopaedic Trauma (Licence: NJ 25MA08474200) |
| Additional Taxonomies | 207XX0801X Orthopaedic Surgery, Orthopaedic Trauma (Licence: WA MD60216210) |
| Enumeration Date | 2008-05-23 |
| Last Update Date | 2015-12-01 |