| NPI | 1023277829 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 174400000X Specialist (Licence: NJ 25MA08810500) |
| Additional Taxonomies | 174400000X Specialist (Licence: NY 238180) |
| 207T00000X Neurological Surgery (Licence: NY 238180) | |
| Enumeration Date | 2008-06-05 |
| Last Update Date | 2021-05-18 |