| NPI | 1700184934 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207T00000X Neurological Surgery (Licence: NY 256140) |
| Additional Taxonomies | 207T00000X Neurological Surgery (Licence: CA 20A12782) |
| Enumeration Date | 2011-03-11 |
| Last Update Date | 2015-06-24 |