| NPI | 1396991881 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207T00000X Neurological Surgery (Licence: CT 71453) |
| Additional Taxonomies | 207T00000X Neurological Surgery (Licence: NY 325495) |
| 207T00000X Neurological Surgery (Licence: NM MD2017-1071) | |
| Enumeration Date | 2008-08-15 |
| Last Update Date | 2023-10-09 |