| NPI | 1720071178 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207T00000X Neurological Surgery (Licence: CT 15262) |
| Additional Taxonomies | 207T00000X Neurological Surgery (Licence: NY 306357) |
| Enumeration Date | 2005-08-31 |
| Last Update Date | 2024-04-20 |