| NPI | 1205816998 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207T00000X Neurological Surgery (Licence: IA MD-49280) |
| Additional Taxonomies | 207T00000X Neurological Surgery (Licence: VA 0101237356) |
| Enumeration Date | 2006-01-19 |
| Last Update Date | 2022-03-03 |