| NPI | 1821094723 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 174400000X Specialist (Licence: NJ MA44365) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: NJ 25MA04436500) |
| Enumeration Date | 2005-06-24 |
| Last Update Date | 2021-05-18 |