| NPI | 1871537027 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 204C00000X Neuromusculoskeletal Medicine, Sports Medicine (Licence: FL OS14386) |
| Additional Taxonomies | 204C00000X Neuromusculoskeletal Medicine, Sports Medicine (Licence: NJ MBO48543NJ) |
| 207X00000X Orthopaedic Surgery (Licence: FL OS14386) | |
| Enumeration Date | 2006-06-16 |
| Last Update Date | 2020-06-02 |