| NPI | 1821229386 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207T00000X Neurological Surgery (Licence: MD D70073) |
| Additional Taxonomies | 207T00000X Neurological Surgery (Licence: NY 236778-1) |
| Enumeration Date | 2009-08-01 |
| Last Update Date | 2021-04-28 |