| NPI | 1265496749 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207T00000X Neurological Surgery (Licence: NY 298772) |
| Additional Taxonomies | 207T00000X Neurological Surgery (Licence: PA MD425117) |
| Enumeration Date | 2006-04-13 |
| Last Update Date | 2019-06-25 |