| NPI | 1679732960 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207T00000X Neurological Surgery (Licence: NY 250371) |
| Additional Taxonomies | 207T00000X Neurological Surgery (Licence: NJ 25MA09432700) |
| Enumeration Date | 2008-06-03 |
| Last Update Date | 2020-06-11 |