| NPI | 1154324135 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207T00000X Neurological Surgery (Licence: NY 197137) |
| Additional Taxonomies | 207T00000X Neurological Surgery (Licence: PA MD054300L) |
| Enumeration Date | 2005-05-24 |
| Last Update Date | 2018-01-23 |