| NPI | 1770688137 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207XP3100X Orthopaedic Surgery, Pediatric Orthopaedic Surgery (Licence: NJ 25MA02926000) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: NJ MA29260) |
| Enumeration Date | 2006-09-13 |
| Last Update Date | 2013-08-23 |