| NPI | 1013160209 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207T00000X Neurological Surgery (Licence: TX R8978) |
| Additional Taxonomies | 207T00000X Neurological Surgery (Licence: NY 390200000x) |
| Enumeration Date | 2008-10-31 |
| Last Update Date | 2020-08-17 |