| NPI | 1134241243 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207T00000X Neurological Surgery (Licence: FL ME124848) |
| Additional Taxonomies | 207T00000X Neurological Surgery (Licence: NJ 25MA09288100) |
| Enumeration Date | 2007-04-06 |
| Last Update Date | 2020-11-12 |