| NPI | 1467670992 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207T00000X Neurological Surgery (Licence: NY 225414) |
| Additional Taxonomies | 207T00000X Neurological Surgery (Licence: NH 13466) |
| Enumeration Date | 2007-04-22 |
| Last Update Date | 2020-08-12 |