NPI | 1720549397 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: NJ 25MA12727000) |
Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: MA 1018963) |
Enumeration Date | 2019-03-27 |
Last Update Date | 2025-07-07 |