| NPI | 1245218072 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207T00000X Neurological Surgery (Licence: PA MD441768) |
| Additional Taxonomies | 207T00000X Neurological Surgery (Licence: NJ 25MA06177400) |
| Enumeration Date | 2006-01-03 |
| Last Update Date | 2011-03-07 |