| NPI | 1629228226 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207T00000X Neurological Surgery (Licence: AZ 47075) |
| Additional Taxonomies | 207T00000X Neurological Surgery (Licence: NY NOT APPLICABLE) |
| 207T00000X Neurological Surgery (Licence: FL 17998) | |
| Enumeration Date | 2008-09-19 |
| Last Update Date | 2018-11-01 |