| NPI | 1922230812 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207XX0005X Orthopaedic Surgery, Sports Medicine (Licence: NJ 25MB09645500) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: MA 260325) |
| 207X00000X Orthopaedic Surgery (Licence: NJ 25MB09645500) | |
| Enumeration Date | 2009-08-11 |
| Last Update Date | 2026-05-18 |