| NPI | 1518126242 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207T00000X Neurological Surgery (Licence: NJ 25MA08957400) |
| Additional Taxonomies | 207T00000X Neurological Surgery (Licence: NY 238627) |
| Enumeration Date | 2008-06-06 |
| Last Update Date | 2011-07-18 |