| NPI | 1487803094 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207T00000X Neurological Surgery (Licence: FL ME 110132) |
| Additional Taxonomies | 207T00000X Neurological Surgery (Licence: NY 232866) |
| Enumeration Date | 2008-09-18 |
| Last Update Date | 2020-12-04 |