| NPI | 1235159815 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207T00000X Neurological Surgery (Licence: MI 4301095381) |
| Additional Taxonomies | 207T00000X Neurological Surgery (Licence: NJ 25MA07466300) |
| Enumeration Date | 2006-07-19 |
| Last Update Date | 2009-10-19 |