| NPI | 1386938843 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207T00000X Neurological Surgery (Licence: NJ 25MA08784400) |
| Additional Taxonomies | 207T00000X Neurological Surgery (Licence: CA A130338) |
| Enumeration Date | 2011-06-01 |
| Last Update Date | 2021-05-28 |