| NPI | 1740416775 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2083P0500X Preventive Medicine, Preventive Medicine/Occupational Environmental Medicine (Licence: NY 283132) |
| Additional Taxonomies | 207T00000X Neurological Surgery (Licence: PA MT195776) |
| Enumeration Date | 2009-06-04 |
| Last Update Date | 2021-06-28 |