| NPI | 1013176734 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207T00000X Neurological Surgery (Licence: FL ME123748) |
| Additional Taxonomies | 207T00000X Neurological Surgery (Licence: NY 275307) |
| Enumeration Date | 2008-06-06 |
| Last Update Date | 2023-02-12 |