| NPI | 1780650390 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207T00000X Neurological Surgery (Licence: PA MD019602E) |
| Additional Taxonomies | 207T00000X Neurological Surgery (Licence: NY 238733-1) |
| Enumeration Date | 2006-02-23 |
| Last Update Date | 2012-01-18 |