| NPI | 1982045845 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207T00000X Neurological Surgery (Licence: NY 271229) |
| Additional Taxonomies | 2085N0700X Radiology, Neuroradiology (Licence: NY P87714) |
| Enumeration Date | 2013-07-08 |
| Last Update Date | 2023-10-16 |