| NPI | 1649629460 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207T00000X Neurological Surgery (Licence: NY 329533) |
| Additional Taxonomies | 207T00000X Neurological Surgery (Licence: CT 78277) |
| Enumeration Date | 2016-06-13 |
| Last Update Date | 2024-08-16 |