| NPI | 1720035926 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207XX0005X Orthopaedic Surgery, Sports Medicine (Licence: NJ 25MA08019200) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: NJ 25MA08019200) |
| 207X00000X Orthopaedic Surgery (Licence: PA MD420433) | |
| 207X00000X Orthopaedic Surgery (Licence: FL ME152830) | |
| 207X00000X Orthopaedic Surgery (Licence: NY 303457) | |
| Enumeration Date | 2006-05-31 |
| Last Update Date | 2022-03-01 |