| NPI | 1659366987 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207T00000X Neurological Surgery (Licence: TX Q6810) |
| Additional Taxonomies | 207T00000X Neurological Surgery (Licence: NJ 25MA08891900) |
| Enumeration Date | 2005-09-13 |
| Last Update Date | 2021-12-07 |