| NPI | 1518196476 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207T00000X Neurological Surgery (Licence: PA MD463495) |
| Additional Taxonomies | 207T00000X Neurological Surgery (Licence: NY 308723) |
| 207T00000X Neurological Surgery (Licence: TN 61935) | |
| Enumeration Date | 2009-07-13 |
| Last Update Date | 2021-05-10 |