| NPI | 1972570588 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207T00000X Neurological Surgery (Licence: NJ MA68972) |
| Additional Taxonomies | 207T00000X Neurological Surgery (Licence: NY 196761) |
| Enumeration Date | 2006-03-02 |
| Last Update Date | 2007-07-08 |