| NPI | 1063486488 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207T00000X Neurological Surgery (Licence: NY 267044) |
| Additional Taxonomies | 174400000X Specialist (Licence: PA MD042521L) |
| Enumeration Date | 2006-02-14 |
| Last Update Date | 2021-03-09 |