| NPI | 1922028349 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207T00000X Neurological Surgery (Licence: GA 50173) |
| Additional Taxonomies | 207T00000X Neurological Surgery (Licence: NY 188904) |
| Enumeration Date | 2006-07-20 |
| Last Update Date | 2011-11-29 |