| NPI | 1598932162 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207T00000X Neurological Surgery (Licence: NY 247982) |
| Additional Taxonomies | 207T00000X Neurological Surgery (Licence: MA 207t00000x) |
| Enumeration Date | 2008-05-13 |
| Last Update Date | 2019-03-18 |