| NPI | 1992712335 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207T00000X Neurological Surgery (Licence: CO DR.0053440) |
| Additional Taxonomies | 207T00000X Neurological Surgery (Licence: NY 226837) |
| Enumeration Date | 2006-08-01 |
| Last Update Date | 2021-06-23 |