| NPI | 1285618843 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085N0700X (Licence: NY 1288861) |
| Additional Taxonomies | 207T00000X Neurological Surgery (Licence: NJ 25MA04764200) |
| Enumeration Date | 2005-12-06 |
| Last Update Date | 2014-04-09 |