| NPI | 1740236793 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: RI 4442) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: NJ 25MA091265000) |
| Enumeration Date | 2006-05-25 |
| Last Update Date | 2012-08-30 |