| NPI | 1023043114 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207T00000X Neurological Surgery (Licence: NY 261941) |
| Additional Taxonomies | 207T00000X Neurological Surgery (Licence: MA 228001) |
| Enumeration Date | 2006-07-11 |
| Last Update Date | 2013-10-17 |