| NPI | 1235191248 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207T00000X Neurological Surgery (Licence: VA 0101240394) |
| Additional Taxonomies | 207T00000X Neurological Surgery (Licence: NY 237651) |
| Enumeration Date | 2006-04-05 |
| Last Update Date | 2022-12-19 |