| NPI | 1760459374 |
|---|---|
| Entity Type | Individual |
| Gender | N/A |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207T00000X Neurological Surgery (Licence: NJ MA53720) |
| Additional Taxonomies | 207T00000X Neurological Surgery (Licence: NY BM1918311) |
| Enumeration Date | 2006-03-02 |
| Last Update Date | 2007-07-08 |