| NPI | 1063603017 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207T00000X Neurological Surgery (Licence: NY 244272) |
| Additional Taxonomies | 207T00000X Neurological Surgery (Licence: PA MD438065) |
| Enumeration Date | 2007-08-06 |
| Last Update Date | 2016-10-05 |