| NPI | 1689606998 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207XX0005X Orthopaedic Surgery, Sports Medicine (Licence: NY 195903) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: NJ 25MA06997300) |
| Enumeration Date | 2006-07-07 |
| Last Update Date | 2016-09-29 |