| NPI | 1114192226 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207T00000X Neurological Surgery (Licence: CT 070803) |
| Additional Taxonomies | 207T00000X Neurological Surgery (Licence: PA MD454095) |
| Enumeration Date | 2008-04-29 |
| Last Update Date | 2023-01-17 |