| NPI | 1477585701 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207T00000X Neurological Surgery (Licence: NY 106683) |
| Additional Taxonomies | 207T00000X Neurological Surgery (Licence: PA 04226014) |
| 207T00000X Neurological Surgery (Licence: NY 1066831) | |
| Enumeration Date | 2006-07-07 |
| Last Update Date | 2010-01-14 |