| NPI | 1154316180 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207T00000X Neurological Surgery (Licence: FL ME122356) |
| Additional Taxonomies | 207T00000X Neurological Surgery (Licence: NY 188337-1) |
| Enumeration Date | 2005-09-15 |
| Last Update Date | 2023-01-30 |