| NPI | 1053508242 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207T00000X Neurological Surgery (Licence: PA MD440154) |
| Additional Taxonomies | 207T00000X Neurological Surgery (Licence: MA 232845) |
| Enumeration Date | 2007-10-01 |
| Last Update Date | 2020-04-27 |