| NPI | 1891899217 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207T00000X Neurological Surgery (Licence: FL ME124685) |
| Additional Taxonomies | 207T00000X Neurological Surgery (Licence: NY 205065) |
| Enumeration Date | 2006-09-08 |
| Last Update Date | 2015-07-08 |