| NPI | 1174564157 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207T00000X Neurological Surgery (Licence: NJ 25MA07930500) |
| Additional Taxonomies | 207T00000X Neurological Surgery (Licence: NY 220840) |
| Enumeration Date | 2006-06-09 |
| Last Update Date | 2024-02-13 |