| NPI | 1366897530 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207T00000X Neurological Surgery (Licence: PA MD482652) |
| Additional Taxonomies | 207T00000X Neurological Surgery (Licence: AZ 68949) |
| 207T00000X Neurological Surgery (Licence: NJ 25MA11983200) | |
| Enumeration Date | 2016-04-25 |
| Last Update Date | 2025-09-03 |