| NPI | 1174843437 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207T00000X Neurological Surgery (Licence: WI 73873) |
| Additional Taxonomies | 207T00000X Neurological Surgery (Licence: NJ 25MA09867600) |
| Enumeration Date | 2010-06-09 |
| Last Update Date | 2020-08-13 |