| NPI | 1215933353 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207T00000X Neurological Surgery (Licence: PA MD462928) |
| Additional Taxonomies | 207T00000X Neurological Surgery (Licence: NJ ma44094) |
| Enumeration Date | 2005-06-23 |
| Last Update Date | 2018-11-27 |