| NPI | 1952361982 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: NY 231631) |
| Additional Taxonomies | 207XX0005X Orthopaedic Surgery, Sports Medicine (Licence: NJ 25MA10258100) |
| 207X00000X Orthopaedic Surgery (Licence: NJ 25MA10258100) | |
| Enumeration Date | 2006-03-24 |
| Last Update Date | 2026-02-13 |