| NPI | 1891704292 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: NJ 25MA06281700) |
| Additional Taxonomies | 174400000X Specialist (Licence: NJ 25MA06281700) |
| Enumeration Date | 2006-08-05 |
| Last Update Date | 2026-02-17 |