| NPI | 1700159555 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207T00000X Neurological Surgery (Licence: GA 67516) |
| Additional Taxonomies | 207T00000X Neurological Surgery (Licence: NY 267037) |
| Enumeration Date | 2012-02-09 |
| Last Update Date | 2014-04-22 |