| NPI | 1952543696 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207T00000X Neurological Surgery (Licence: NJ 25MA08897500) |
| Additional Taxonomies | 207T00000X Neurological Surgery (Licence: PA MD438655) |
| Enumeration Date | 2009-03-26 |
| Last Update Date | 2018-02-23 |