| NPI | 1750318689 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207T00000X Neurological Surgery (Licence: PA MD067853L) |
| Additional Taxonomies | 207T00000X Neurological Surgery (Licence: NJ 25MA10724400) |
| 207T00000X Neurological Surgery (Licence: OH 35.147099) | |
| Enumeration Date | 2006-06-27 |
| Last Update Date | 2023-06-08 |