| NPI | 1922134394 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207T00000X Neurological Surgery (Licence: PA MD439860) |
| Additional Taxonomies | 207T00000X Neurological Surgery (Licence: MA L-223111) |
| 207T00000X Neurological Surgery (Licence: NJ 25MA09202300) | |
| Enumeration Date | 2007-02-27 |
| Last Update Date | 2013-02-20 |