| NPI | 1710949276 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 174400000X Specialist (Licence: NJ MA053392) |
| Additional Taxonomies | 207XS0117X Orthopaedic Surgery, Orthopaedic Surgery of the Spine (Licence: NJ MA05339200) |
| Enumeration Date | 2006-04-03 |
| Last Update Date | 2021-02-12 |