| NPI | 1942315155 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207T00000X Neurological Surgery (Licence: NY 199352) |
| Additional Taxonomies | 207T00000X Neurological Surgery (Licence: FL ME79239) |
| Enumeration Date | 2006-08-20 |
| Last Update Date | 2021-04-01 |