| NPI | 1952507774 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207T00000X Neurological Surgery (Licence: NJ 25MA10662700) |
| Additional Taxonomies | 207T00000X Neurological Surgery (Licence: LA 208174) |
| Enumeration Date | 2007-06-27 |
| Last Update Date | 2021-07-23 |