| NPI | 1720076706 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207T00000X Neurological Surgery (Licence: PA MD048313L) |
| Additional Taxonomies | 207T00000X Neurological Surgery (Licence: DE C1-0013235) |
| 207T00000X Neurological Surgery (Licence: NJ 25MA06897900) | |
| Enumeration Date | 2005-10-12 |
| Last Update Date | 2026-03-12 |