| NPI | 1033476569 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207T00000X Neurological Surgery (Licence: NJ 25MA11101500) |
| Additional Taxonomies | 207T00000X Neurological Surgery (Licence: CO DR.0063720) |
| 207T00000X Neurological Surgery (Licence: IA MD-45124) | |
| 207T00000X Neurological Surgery (Licence: IA R-9419) | |
| Enumeration Date | 2012-04-22 |
| Last Update Date | 2024-05-09 |