| NPI | 1124078027 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207T00000X Neurological Surgery (Licence: MN 42776) |
| Additional Taxonomies | 207T00000X Neurological Surgery (Licence: NY 237509) |
| Enumeration Date | 2006-05-11 |
| Last Update Date | 2025-04-15 |