| NPI | 1578825097 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207T00000X Neurological Surgery (Licence: NY 297797) |
| Additional Taxonomies | 207T00000X Neurological Surgery (Licence: LA 323761) |
| Enumeration Date | 2012-06-11 |
| Last Update Date | 2022-02-15 |