| NPI | 1518499540 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207T00000X Neurological Surgery (Licence: NJ 25MA12640600) |
| Additional Taxonomies | 207T00000X Neurological Surgery (Licence: NY 328617-01) |
| Enumeration Date | 2017-03-29 |
| Last Update Date | 2025-11-26 |