| NPI | 1154536191 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207T00000X Neurological Surgery (Licence: OR MD157718) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: OR MD157718) |
| Enumeration Date | 2007-05-12 |
| Last Update Date | 2022-08-15 |