NPI | 1982861654 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: NJ 25MA08978400) |
Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: NY 248088) |
207XX0005X Orthopaedic Surgery, Sports Medicine (Licence: NJ 25MA08978400) | |
Enumeration Date | 2008-05-20 |
Last Update Date | 2019-03-26 |