| NPI | 1811308372 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207T00000X Neurological Surgery (Licence: NY 311268) |
| Additional Taxonomies | 207T00000X Neurological Surgery (Licence: NJ 25MA10568500) |
| 207T00000X Neurological Surgery (Licence: PA MD473295) | |
| Enumeration Date | 2014-05-17 |
| Last Update Date | 2022-08-01 |