| NPI | 1740214287 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207T00000X Neurological Surgery (Licence: NY 243228) |
| Additional Taxonomies | 207T00000X Neurological Surgery (Licence: MN 33774) |
| Enumeration Date | 2006-07-10 |
| Last Update Date | 2013-10-17 |