| NPI | 1962656579 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207XP3100X Orthopaedic Surgery, Pediatric Orthopaedic Surgery (Licence: NJ 25MA09147600) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: CA A119886) |
| 207X00000X Orthopaedic Surgery (Licence: NY 250629) | |
| Enumeration Date | 2008-11-10 |
| Last Update Date | 2019-10-24 |