| NPI | 1881080190 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207XX0005X Orthopaedic Surgery, Sports Medicine (Licence: NJ 25MA10947000) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: NJ 25MA10947000) |
| Enumeration Date | 2015-04-13 |
| Last Update Date | 2024-12-16 |