| NPI | 1760518807 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207T00000X Neurological Surgery (Licence: FL ME170614) |
| Additional Taxonomies | 207T00000X Neurological Surgery (Licence: NY 261037) |
| 207T00000X Neurological Surgery (Licence: MD D77078) | |
| Enumeration Date | 2007-02-25 |
| Last Update Date | 2024-10-11 |