| NPI | 1306882279 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207T00000X Neurological Surgery (Licence: NY 196968) |
| Additional Taxonomies | 207T00000X Neurological Surgery (Licence: PA MD072435L) |
| 207T00000X Neurological Surgery (Licence: FL ME139330) | |
| Enumeration Date | 2006-06-21 |
| Last Update Date | 2021-06-07 |