| NPI | 1366694895 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207T00000X Neurological Surgery (Licence: NH 15965) |
| Additional Taxonomies | 207T00000X Neurological Surgery (Licence: NY 244605) |
| Enumeration Date | 2008-10-15 |
| Last Update Date | 2013-01-14 |