| NPI | 1760533616 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: MD H78771) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: NJ 25MB07758400) |
| Enumeration Date | 2007-01-16 |
| Last Update Date | 2020-06-08 |