| NPI | 1285069401 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207T00000X Neurological Surgery (Licence: NJ 25MA11212300) |
| Additional Taxonomies | 207T00000X Neurological Surgery (Licence: CA A170673) |
| Enumeration Date | 2013-09-06 |
| Last Update Date | 2022-08-19 |