| NPI | 1225357098 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207T00000X Neurological Surgery (Licence: NY 294452) |
| Additional Taxonomies | 207T00000X Neurological Surgery (Licence: RI MD15742) |
| Enumeration Date | 2010-05-19 |
| Last Update Date | 2022-06-03 |