| NPI | 1962457028 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: NJ MA 41531) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: NY 165189-1) |
| Enumeration Date | 2006-05-24 |
| Last Update Date | 2010-07-02 |