| NPI | 1174658272 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207T00000X Neurological Surgery (Licence: OH 35.134660) |
| Additional Taxonomies | 207T00000X Neurological Surgery (Licence: NJ 25MA07461000) |
| Enumeration Date | 2007-02-22 |
| Last Update Date | 2019-03-29 |