| NPI | 1356701577 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207T00000X Neurological Surgery (Licence: VA 0102209368) |
| Additional Taxonomies | 207T00000X Neurological Surgery (Licence: NY 322248) |
| 207T00000X Neurological Surgery (Licence: NJ 25MB11484600) | |
| Enumeration Date | 2016-03-01 |
| Last Update Date | 2025-06-24 |