| NPI | 1457707697 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207T00000X Neurological Surgery (Licence: NJ 25MB12374300) |
| Additional Taxonomies | 2085N0700X Radiology, Neuroradiology (Licence: NJ 25MB12374300) |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: NJ 25MB12374300) | |
| Enumeration Date | 2016-05-06 |
| Last Update Date | 2024-10-15 |