| NPI | 1316042989 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207T00000X Neurological Surgery (Licence: NJ 25MA09005200) |
| Additional Taxonomies | 207T00000X Neurological Surgery (Licence: NY 251625) |
| Enumeration Date | 2006-09-14 |
| Last Update Date | 2024-04-05 |