| NPI | 1114134921 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207T00000X Neurological Surgery (Licence: NH 24582) |
| Additional Taxonomies | 207T00000X Neurological Surgery (Licence: NJ 25MA09578700) |
| 207T00000X Neurological Surgery (Licence: PA MD447804) | |
| Enumeration Date | 2007-05-17 |
| Last Update Date | 2023-08-24 |