| NPI | 1184683708 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207T00000X Neurological Surgery (Licence: ME MD18438) |
| Additional Taxonomies | 207T00000X Neurological Surgery (Licence: NY 230442) |
| Enumeration Date | 2006-03-22 |
| Last Update Date | 2012-03-06 |