| NPI | 1053591024 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207T00000X Neurological Surgery (Licence: MD D91181) |
| Additional Taxonomies | 207T00000X Neurological Surgery (Licence: PA MD437666) |
| 207T00000X Neurological Surgery (Licence: NJ 25MA08778100) | |
| Enumeration Date | 2007-11-07 |
| Last Update Date | 2021-07-07 |