| NPI | 1558899468 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207T00000X Neurological Surgery (Licence: GA 101091) |
| Additional Taxonomies | 207T00000X Neurological Surgery (Licence: NJ 25MB11401600) |
| Enumeration Date | 2017-05-23 |
| Last Update Date | 2024-07-22 |