| NPI | 1356368492 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207T00000X Neurological Surgery (Licence: NJ 25MA08474500) |
| Additional Taxonomies | 207T00000X Neurological Surgery (Licence: PA MD-066797-L) |
| Enumeration Date | 2006-07-16 |
| Last Update Date | 2018-02-28 |