NPI | 1710116835 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: NJ 25MA08639800) |
Additional Taxonomies | 207XX0005X Orthopaedic Surgery, Sports Medicine (Licence: NJ 25MA08639800) |
Enumeration Date | 2009-07-10 |
Last Update Date | 2023-05-03 |