| NPI | 1720078322 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207T00000X Neurological Surgery (Licence: NJ 25MB07544500) |
| Additional Taxonomies | 207T00000X Neurological Surgery (Licence: PA OS009981L) |
| Enumeration Date | 2005-10-25 |
| Last Update Date | 2022-11-10 |