| NPI | 1225214166 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207T00000X Neurological Surgery (Licence: PA MD475645) |
| Additional Taxonomies | 207T00000X Neurological Surgery (Licence: AZ 48925) |
| Enumeration Date | 2008-01-10 |
| Last Update Date | 2021-10-07 |