| NPI | 1760699920 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207T00000X Neurological Surgery (Licence: WV 29884) |
| Additional Taxonomies | 207T00000X Neurological Surgery (Licence: NJ 25MA12262100) |
| Enumeration Date | 2007-05-17 |
| Last Update Date | 2024-06-13 |