| NPI | 1235347980 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207T00000X Neurological Surgery (Licence: WA MD60626539) |
| Additional Taxonomies | 207T00000X Neurological Surgery (Licence: MA 243127) |
| 207T00000X Neurological Surgery (Licence: DC MD039810) | |
| 207T00000X Neurological Surgery (Licence: VA 0101250293) | |
| 207T00000X Neurological Surgery (Licence: MD D73185) | |
| Enumeration Date | 2007-05-18 |
| Last Update Date | 2017-05-02 |