| NPI | 1033433966 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207T00000X Neurological Surgery (Licence: NJ 25MB10499200) |
| Additional Taxonomies | 207T00000X Neurological Surgery (Licence: PA OT012909) |
| Enumeration Date | 2010-03-22 |
| Last Update Date | 2024-04-15 |