| NPI | 1114993367 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207T00000X Neurological Surgery (Licence: MD D0042536) |
| Additional Taxonomies | 207T00000X Neurological Surgery (Licence: VA 0101052485) |
| 2084N0400X Psychiatry & Neurology, Neurology (Licence: VA 0101052485) | |
| Enumeration Date | 2006-02-27 |
| Last Update Date | 2024-02-14 |