| NPI | 1275553455 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207T00000X Neurological Surgery (Licence: PA MD-023976-E) |
| Additional Taxonomies | 207T00000X Neurological Surgery (Licence: NJ 25MA08008900) |
| Enumeration Date | 2006-07-20 |
| Last Update Date | 2015-01-16 |