| NPI | 1750430260 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: NJ 25MA05466300) |
| Additional Taxonomies | 207XS0117X Orthopaedic Surgery, Orthopaedic Surgery of the Spine (Licence: NJ 25MA05466300) |
| Enumeration Date | 2007-01-10 |
| Last Update Date | 2023-03-06 |