| NPI | 1477663144 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207T00000X Neurological Surgery (Licence: NY 214626) |
| Additional Taxonomies | 207T00000X Neurological Surgery (Licence: GA 049378) |
| Enumeration Date | 2006-08-30 |
| Last Update Date | 2022-07-21 |