| NPI | 1306878806 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207T00000X Neurological Surgery (Licence: NJ 25MA13167200) |
| Additional Taxonomies | 207T00000X Neurological Surgery (Licence: TX J2492) |
| 207T00000X Neurological Surgery (Licence: FL ME110809) | |
| Enumeration Date | 2006-07-07 |
| Last Update Date | 2026-06-26 |