| NPI | 1740365436 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207T00000X Neurological Surgery (Licence: NM MD2019-0806) |
| Additional Taxonomies | 207T00000X Neurological Surgery (Licence: NY 285851) |
| 207T00000X Neurological Surgery (Licence: UT 5126992-1205) | |
| 207T00000X Neurological Surgery (Licence: ME MD27467) | |
| Enumeration Date | 2006-10-25 |
| Last Update Date | 2024-04-22 |