| 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 |