| NPI | 1710961107 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207XX0005X Orthopaedic Surgery, Sports Medicine (Licence: NJ 25MA07975200) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: NJ 25MA07975200) |
| Enumeration Date | 2005-11-30 |
| Last Update Date | 2023-11-22 |