| NPI | 1043541956 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207T00000X Neurological Surgery (Licence: NY 292729) |
| Additional Taxonomies | 207T00000X Neurological Surgery (Licence: MA 237057) |
| 207T00000X Neurological Surgery (Licence: NY 97860) | |
| 207T00000X Neurological Surgery (Licence: PA MD477384) | |
| Enumeration Date | 2010-01-18 |
| Last Update Date | 2022-06-13 |