| NPI | 1255472940 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207T00000X Neurological Surgery (Licence: NJ 25MA06243100) |
| Additional Taxonomies | 207T00000X Neurological Surgery (Licence: NY 199245) |
| Enumeration Date | 2007-02-08 |
| Last Update Date | 2010-07-01 |