| NPI | 1669492625 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207T00000X Neurological Surgery (Licence: PA MD032167E) |
| Additional Taxonomies | 207T00000X Neurological Surgery (Licence: NJ 25MA06609100) |
| Enumeration Date | 2006-07-20 |
| Last Update Date | 2012-08-14 |