| NPI | 1366576845 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207T00000X Neurological Surgery (Licence: NJ 25MA08237500) |
| Additional Taxonomies | 207T00000X Neurological Surgery (Licence: NY 225430) |
| Enumeration Date | 2007-03-15 |
| Last Update Date | 2024-04-15 |