| NPI | 1902123920 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207T00000X Neurological Surgery (Licence: WI 20831) |
| Additional Taxonomies | 207T00000X Neurological Surgery (Licence: NY 266530) |
| 207T00000X Neurological Surgery (Licence: CA A122831) | |
| Enumeration Date | 2010-04-30 |
| Last Update Date | 2021-11-18 |