| NPI | 1003299629 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207T00000X Neurological Surgery (Licence: PA MD461955) |
| Additional Taxonomies | 207T00000X Neurological Surgery (Licence: WA 60527113) |
| Enumeration Date | 2015-06-30 |
| Last Update Date | 2020-08-31 |