| NPI | 1720288244 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207T00000X Neurological Surgery (Licence: NJ 25MA10643300) |
| Additional Taxonomies | 207T00000X Neurological Surgery (Licence: WA MD60830245) |
| Enumeration Date | 2007-07-23 |
| Last Update Date | 2019-10-17 |