| NPI | 1548471907 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207T00000X Neurological Surgery (Licence: NJ 25MA09977300) |
| Additional Taxonomies | 207T00000X Neurological Surgery (Licence: MO 2012008252) |
| Enumeration Date | 2007-05-25 |
| Last Update Date | 2024-11-13 |