| NPI | 1649363797 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207XP3100X Orthopaedic Surgery, Pediatric Orthopaedic Surgery (Licence: NJ 25MA11722800) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: VA 0101052990) |
| Enumeration Date | 2006-10-02 |
| Last Update Date | 2023-11-03 |