| NPI | 1053519256 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207T00000X Neurological Surgery (Licence: MD D0076900) |
| Additional Taxonomies | 207T00000X Neurological Surgery (Licence: PA MT190445) |
| Enumeration Date | 2007-07-10 |
| Last Update Date | 2015-02-12 |