| NPI | 1194726216 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207T00000X Neurological Surgery (Licence: PA MD465013) |
| Additional Taxonomies | 207T00000X Neurological Surgery (Licence: SC 28426) |
| Enumeration Date | 2005-08-10 |
| Last Update Date | 2021-03-25 |