| NPI | 1114314440 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207T00000X Neurological Surgery (Licence: NY 322049) |
| Additional Taxonomies | 207T00000X Neurological Surgery (Licence: MO 2022007477) |
| Enumeration Date | 2015-04-24 |
| Last Update Date | 2023-06-28 |