| NPI | 1700913738 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207T00000X Neurological Surgery (Licence: CO 42756) |
| Additional Taxonomies | 207T00000X Neurological Surgery (Licence: NY 286555) |
| Enumeration Date | 2007-02-27 |
| Last Update Date | 2021-12-15 |