| NPI | 1427111681 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207T00000X Neurological Surgery (Licence: GA 84122) |
| Additional Taxonomies | 207T00000X Neurological Surgery (Licence: PA MD423616) |
| 207T00000X Neurological Surgery (Licence: NY 257848-1) | |
| 207T00000X Neurological Surgery (Licence: NJ 25MA08827200) | |
| Enumeration Date | 2006-12-19 |
| Last Update Date | 2020-04-24 |