| NPI | 1548429038 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207T00000X Neurological Surgery (Licence: NJ 25MA09425900) |
| Additional Taxonomies | 207T00000X Neurological Surgery (Licence: NY 250617) |
| Enumeration Date | 2008-06-09 |
| Last Update Date | 2014-07-24 |