| NPI | 1992825954 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: CA A104292) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: NJ 25MA12790900) |
| Enumeration Date | 2007-03-30 |
| Last Update Date | 2025-11-17 |