| NPI | 1730146820 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207T00000X Neurological Surgery (Licence: NJ 25MA07740900) |
| Additional Taxonomies | 207T00000X Neurological Surgery (Licence: PA MD070178L) |
| Enumeration Date | 2006-05-01 |
| Last Update Date | 2024-01-16 |