| NPI | 1114378551 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207T00000X Neurological Surgery (Licence: NY 321745) |
| Additional Taxonomies | 207T00000X Neurological Surgery (Licence: MO 2020039509) |
| 207T00000X Neurological Surgery (Licence: MO 2016021529) | |
| Enumeration Date | 2016-06-27 |
| Last Update Date | 2023-08-03 |