| NPI | 1891012183 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: NJ 25MA09847900) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: NY 275857) |
| Enumeration Date | 2010-04-26 |
| Last Update Date | 2019-10-01 |