| NPI | 1871804211 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: NJ 25MA09380400) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: FL ME122493) |
| 207XS0114X Orthopaedic Surgery Adult Reconstructive Orthopaedic Surgery (Licence: NJ 25MA09380400) | |
| Enumeration Date | 2010-06-30 |
| Last Update Date | 2020-02-03 |