| NPI | 1205045424 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207T00000X Neurological Surgery (Licence: NY 243524) |
| Additional Taxonomies | 174400000X Specialist (Licence: NY 243524) |
| Enumeration Date | 2007-05-22 |
| Last Update Date | 2019-10-15 |