| NPI | 1013216472 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207T00000X Neurological Surgery (Licence: NJ 25MA10102100) |
| Additional Taxonomies | 207T00000X Neurological Surgery (Licence: PA MD460820) |
| Enumeration Date | 2011-03-23 |
| Last Update Date | 2022-07-21 |