| NPI | 1225237795 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207T00000X Neurological Surgery (Licence: NC 2018-01255) |
| Additional Taxonomies | 207T00000X Neurological Surgery (Licence: NY 244457) |
| Enumeration Date | 2007-07-16 |
| Last Update Date | 2020-10-26 |