| NPI | 1407877210 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207T00000X Neurological Surgery (Licence: NY 151452) |
| Additional Taxonomies | 207T00000X Neurological Surgery (Licence: GA 053874) |
| Enumeration Date | 2006-07-21 |
| Last Update Date | 2020-02-20 |