| NPI | 1154348175 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207T00000X Neurological Surgery (Licence: NJ 25MA06614000) |
| Additional Taxonomies | 207T00000X Neurological Surgery (Licence: PA MD424987) |
| Enumeration Date | 2006-07-16 |
| Last Update Date | 2018-02-23 |