| NPI | 1225020894 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207T00000X Neurological Surgery (Licence: NM MD2018-0112) |
| Additional Taxonomies | 207T00000X Neurological Surgery (Licence: MI PD073182) |
| Enumeration Date | 2005-08-18 |
| Last Update Date | 2018-07-09 |