| NPI | 1356322697 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207T00000X Neurological Surgery (Licence: NY 1752211) |
| Additional Taxonomies | 207T00000X Neurological Surgery (Licence: NJ MA52820) |
| Enumeration Date | 2005-11-11 |
| Last Update Date | 2011-06-24 |