| NPI | 1457504490 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207T00000X Neurological Surgery (Licence: NY 281906) |
| Additional Taxonomies | 2085N0700X Radiology Neuroradiology (Licence: NY 281906) |
| Enumeration Date | 2008-11-03 |
| Last Update Date | 2022-10-11 |