| NPI | 1134329402 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207T00000X Neurological Surgery (Licence: VA 0101244138) |
| Additional Taxonomies | 2086S0120X Surgery, Pediatric Surgery (Licence: PA MD422479) |
| 207T00000X Neurological Surgery (Licence: ME MD23462) | |
| 2086S0120X Surgery, Pediatric Surgery (Licence: VA 0101244138) | |
| Enumeration Date | 2007-07-24 |
| Last Update Date | 2020-05-28 |