| NPI | 1043320252 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207T00000X Neurological Surgery (Licence: MD D0057234) |
| Additional Taxonomies | 207T00000X Neurological Surgery (Licence: VA 0101221427) |
| Enumeration Date | 2006-08-30 |
| Last Update Date | 2019-07-11 |