| NPI | 1164438743 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207T00000X Neurological Surgery (Licence: ND 8573) |
| Additional Taxonomies | 207T00000X Neurological Surgery (Licence: NM 20020410) |
| 207T00000X Neurological Surgery (Licence: PA MD423288) | |
| Enumeration Date | 2006-08-01 |
| Last Update Date | 2022-10-07 |