| NPI | 1053750489 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207T00000X Neurological Surgery (Licence: PA MD476342) |
| Additional Taxonomies | 207T00000X Neurological Surgery (Licence: NJ 25MA11385500) |
| Enumeration Date | 2013-06-19 |
| Last Update Date | 2026-04-15 |