| NPI | 1962799221 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207T00000X Neurological Surgery (Licence: NJ 25MA10328900) |
| Additional Taxonomies | 207T00000X Neurological Surgery (Licence: MS T-2492) |
| Enumeration Date | 2011-07-06 |
| Last Update Date | 2022-02-02 |