| NPI | 1528098795 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207T00000X Neurological Surgery (Licence: AR E-8916) |
| Additional Taxonomies | 207T00000X Neurological Surgery (Licence: NY 275131-1) |
| 207T00000X Neurological Surgery (Licence: ME MD19821) | |
| 207T00000X Neurological Surgery (Licence: MN 37452) | |
| 207T00000X Neurological Surgery (Licence: WI 40036) | |
| Enumeration Date | 2006-07-04 |
| Last Update Date | 2023-03-07 |