| NPI | 1528038528 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207T00000X Neurological Surgery (Licence: NY 291504) |
| Additional Taxonomies | 207T00000X Neurological Surgery (Licence: VA 0101236200) |
| Enumeration Date | 2006-01-24 |
| Last Update Date | 2023-06-29 |