| NPI | 1982699823 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207T00000X Neurological Surgery (Licence: PA MD431277) |
| Additional Taxonomies | 207T00000X Neurological Surgery (Licence: NJ 25MA08005300) |
| 174400000X Specialist (Licence: NY 231546-1) | |
| Enumeration Date | 2005-09-16 |
| Last Update Date | 2010-09-21 |