| NPI | 1215957337 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207T00000X Neurological Surgery (Licence: PA MD071128L) |
| Additional Taxonomies | 207T00000X Neurological Surgery (Licence: NJ 25MA07495700) |
| Enumeration Date | 2006-07-20 |
| Last Update Date | 2018-11-20 |