| NPI | 1538107545 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207T00000X Neurological Surgery (Licence: PA md066999l) |
| Additional Taxonomies | 207T00000X Neurological Surgery (Licence: NJ 25MA08007100) |
| Enumeration Date | 2006-06-02 |
| Last Update Date | 2023-03-07 |