| NPI | 1558907998 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207T00000X Neurological Surgery (Licence: NY 301203) |
| Additional Taxonomies | 2086S0102X Surgery, Surgical Critical Care (Licence: NY 301203) |
| Enumeration Date | 2019-11-20 |
| Last Update Date | 2019-11-20 |