NPI | 1760942288 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: NJ 25MA12757400) |
Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: CO DR.0072755) |
207XX0005X Orthopaedic Surgery, Sports Medicine (Licence: CO DR.0072755) | |
Enumeration Date | 2019-03-21 |
Last Update Date | 2025-09-18 |