NPI | 1154354785 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 207T00000X Neurological Surgery (Licence: NY 307830) |
Additional Taxonomies | 207T00000X Neurological Surgery (Licence: DC MD038299) |
207PE0005X Emergency Medicine, Undersea and Hyperbaric Medicine (Licence: HI 13279) | |
Enumeration Date | 2006-07-08 |
Last Update Date | 2020-12-18 |