| NPI | 1629132006 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207T00000X Neurological Surgery (Licence: PA MD437909) |
| Additional Taxonomies | 207T00000X Neurological Surgery (Licence: MO 2006018983) |
| 207T00000X Neurological Surgery (Licence: NJ 25MA08698500) | |
| Enumeration Date | 2006-12-20 |
| Last Update Date | 2018-12-06 |