| NPI | 1760988901 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207T00000X Neurological Surgery (Licence: NJ 25MA11789000) |
| Additional Taxonomies | 207T00000X Neurological Surgery (Licence: PA MD488178) |
| Enumeration Date | 2018-04-05 |
| Last Update Date | 2026-03-18 |