| NPI | 1194712430 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207T00000X Neurological Surgery (Licence: NJ 25MA09749600) |
| Additional Taxonomies | 207T00000X Neurological Surgery (Licence: PA MD019333E) |
| Enumeration Date | 2005-10-03 |
| Last Update Date | 2015-08-12 |