| NPI | 1932485752 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207T00000X Neurological Surgery (Licence: NJ 25MA08628200) |
| Additional Taxonomies | 207T00000X Neurological Surgery (Licence: NY 270219) |
| Enumeration Date | 2011-10-25 |
| Last Update Date | 2023-08-14 |