| NPI | 1609289875 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207T00000X Neurological Surgery (Licence: NY 318055) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MA 259329) |
| 2085N0700X Radiology, Neuroradiology (Licence: NY 318055) | |
| Enumeration Date | 2014-06-05 |
| Last Update Date | 2022-11-16 |