| NPI | 1356305049 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207T00000X Neurological Surgery (Licence: NY 187561) |
| Additional Taxonomies | 207T00000X Neurological Surgery (Licence: NJ 25MA06408200) |
| Enumeration Date | 2006-04-12 |
| Last Update Date | 2023-08-28 |