| NPI | 1225055221 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207T00000X Neurological Surgery (Licence: DE C1-0013399) |
| Additional Taxonomies | 207T00000X Neurological Surgery (Licence: PA MD-072695-L) |
| Enumeration Date | 2006-07-16 |
| Last Update Date | 2020-06-02 |