| NPI | 1720069438 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207T00000X Neurological Surgery (Licence: CA C1561324) |
| Additional Taxonomies | 207T00000X Neurological Surgery (Licence: NY 217720-1) |
| 207T00000X Neurological Surgery (Licence: NJ 25MA07917400) | |
| Enumeration Date | 2005-11-09 |
| Last Update Date | 2020-06-22 |