| NPI | 1265993216 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207T00000X Neurological Surgery (Licence: NJ 25MA12326300) |
| Additional Taxonomies | 207T00000X Neurological Surgery (Licence: NY 342350) |
| Enumeration Date | 2019-03-30 |
| Last Update Date | 2026-07-25 |