| NPI | 1831161751 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207XP3100X Orthopaedic Surgery, Pediatric Orthopaedic Surgery (Licence: NJ 25MA05303900) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: NJ MA53039) |
| 207X00000X Orthopaedic Surgery (Licence: CT 64729) | |
| Enumeration Date | 2006-02-03 |
| Last Update Date | 2020-12-10 |