| NPI | 1487826079 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207T00000X Neurological Surgery (Licence: GA 64902) |
| Additional Taxonomies | 207T00000X Neurological Surgery (Licence: NY 234690) |
| Enumeration Date | 2008-03-24 |
| Last Update Date | 2019-06-20 |