| NPI | 1265484786 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207T00000X Neurological Surgery (Licence: WY 15480A) |
| Additional Taxonomies | 207T00000X Neurological Surgery (Licence: PA MD418858) |
| Enumeration Date | 2006-05-16 |
| Last Update Date | 2023-02-17 |