| NPI | 1972762276 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: NJ 25MA09119100) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: NY 62521) |
| Enumeration Date | 2008-06-03 |
| Last Update Date | 2019-09-30 |