| NPI | 1689808107 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207T00000X Neurological Surgery (Licence: KY 03961) |
| Additional Taxonomies | 207T00000X Neurological Surgery (Licence: NJ AS2593778-C17) |
| Enumeration Date | 2009-05-12 |
| Last Update Date | 2022-09-26 |