| NPI | 1922086644 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207T00000X Neurological Surgery (Licence: NE 14896) |
| Additional Taxonomies | 207T00000X Neurological Surgery (Licence: MN 22153) |
| 207T00000X Neurological Surgery (Licence: NY 120332-1) | |
| Enumeration Date | 2006-01-03 |
| Last Update Date | 2023-08-30 |