| NPI | 1609001130 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207T00000X Neurological Surgery (Licence: NJ 25MA09852900) |
| Additional Taxonomies | 2085N0700X Radiology, Neuroradiology (Licence: MA N/a) |
| 207T00000X Neurological Surgery (Licence: PA MD457829) | |
| Enumeration Date | 2009-05-28 |
| Last Update Date | 2016-07-13 |