| NPI | 1366530321 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207T00000X Neurological Surgery (Licence: VA 010268834) |
| Additional Taxonomies | 207T00000X Neurological Surgery (Licence: CA C161473) |
| 207T00000X Neurological Surgery (Licence: NY 220972) | |
| 207T00000X Neurological Surgery (Licence: IA MD-43153) | |
| Enumeration Date | 2006-10-11 |
| Last Update Date | 2020-10-14 |