| 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 |