| NPI | 1114116464 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207T00000X Neurological Surgery (Licence: NJ 25MA08517100) |
| Additional Taxonomies | 207T00000X Neurological Surgery (Licence: PA MT182279) |
| 207T00000X Neurological Surgery (Licence: PA MD-433793) | |
| Enumeration Date | 2007-10-22 |
| Last Update Date | 2014-02-05 |