| NPI | 1194179077 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207T00000X Neurological Surgery (Licence: PA MD480761) |
| Additional Taxonomies | 207T00000X Neurological Surgery (Licence: NJ 25MA11158700) |
| Enumeration Date | 2016-04-18 |
| Last Update Date | 2025-04-22 |