| NPI | 1962849331 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 163WR0006X Registered Nurse, Registered Nurse First Assistant (Licence: NJ 26NR08930300) |
| Additional Taxonomies | 207T00000X Neurological Surgery (Licence: NJ 25MA08810500) |
| Enumeration Date | 2013-05-25 |
| Last Update Date | 2017-03-10 |