| NPI | 1922042720 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: NY 188735-1) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: NJ 25MA08100000) |
| Enumeration Date | 2006-06-15 |
| Last Update Date | 2010-01-14 |