| NPI | 1669552808 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207T00000X Neurological Surgery (Licence: CA 000000A91714) |
| Additional Taxonomies | 207T00000X Neurological Surgery (Licence: NY 216472) |
| Enumeration Date | 2006-10-16 |
| Last Update Date | 2023-04-25 |