| NPI | 1508132200 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207T00000X Neurological Surgery (Licence: NJ 25MA10680000) |
| Additional Taxonomies | 207T00000X Neurological Surgery (Licence: PA MD470272) |
| Enumeration Date | 2012-03-27 |
| Last Update Date | 2022-01-24 |