| NPI | 1801847942 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207XX0005X Orthopaedic Surgery, Sports Medicine (Licence: NJ 25MA03307600) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: NJ MA33076) |
| Enumeration Date | 2006-05-13 |
| Last Update Date | 2018-11-13 |