| NPI | 1427043454 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207T00000X Neurological Surgery (Licence: MI 4301097635) |
| Additional Taxonomies | 207T00000X Neurological Surgery (Licence: NY 208307-1) |
| Enumeration Date | 2005-09-15 |
| Last Update Date | 2018-03-26 |