| NPI | 1972525541 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207T00000X Neurological Surgery (Licence: NJ 25MA1132290) |
| Additional Taxonomies | 207T00000X Neurological Surgery (Licence: ND 8731) |
| 207T00000X Neurological Surgery (Licence: MA 233650) | |
| Enumeration Date | 2006-07-24 |
| Last Update Date | 2022-02-17 |