| NPI | 1750484200 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207T00000X Neurological Surgery (Licence: NY 283046) |
| Additional Taxonomies | 207T00000X Neurological Surgery (Licence: NH 14568) |
| 207T00000X Neurological Surgery (Licence: ME MD20673) | |
| Enumeration Date | 2006-09-07 |
| Last Update Date | 2023-03-23 |