NPI | 1932293255 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: NJ 25MA06919900) |
Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: NY 203522) |
207XX0005X Orthopaedic Surgery, Sports Medicine (Licence: NJ 25ma06919900) | |
Enumeration Date | 2006-10-03 |
Last Update Date | 2021-05-28 |