| NPI | 1699752048 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207T00000X Neurological Surgery (Licence: NY 224683) |
| Additional Taxonomies | 207T00000X Neurological Surgery (Licence: PA MD473553) |
| Enumeration Date | 2005-12-28 |
| Last Update Date | 2023-09-24 |