| NPI | 1336529924 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207T00000X Neurological Surgery (Licence: NY 329076) |
| Additional Taxonomies | 207T00000X Neurological Surgery (Licence: UT 12797459-1205) |
| Enumeration Date | 2015-06-09 |
| Last Update Date | 2024-05-09 |