| NPI | 1912098187 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207XX0004X Orthopaedic Surgery, Foot and Ankle Surgery (Licence: NJ 25MA07184700) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: NY 201777) |
| Enumeration Date | 2006-09-27 |
| Last Update Date | 2020-06-09 |