| NPI | 1265938773 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207T00000X Neurological Surgery (Licence: NY 334036-01) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: NY 334036-01) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| 207T00000X Neurological Surgery (Licence: NJ 25MA12762800) | |
| Enumeration Date | 2018-04-03 |
| Last Update Date | 2026-08-20 |