| NPI | 1477226587 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207T00000X Neurological Surgery (Licence: NY 322852-01) |
| Additional Taxonomies | 207T00000X Neurological Surgery (Licence: NY P109510) |
| Enumeration Date | 2021-07-26 |
| Last Update Date | 2023-07-05 |