| NPI | 1831176254 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207XX0005X Orthopaedic Surgery, Sports Medicine (Licence: NJ 25MA07460700) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: NY 192430) |
| Enumeration Date | 2005-12-28 |
| Last Update Date | 2019-03-21 |