| NPI | 1285654632 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207T00000X Neurological Surgery (Licence: MD D0051043) |
| Additional Taxonomies | 207T00000X Neurological Surgery (Licence: WV 18854) |
| Enumeration Date | 2006-07-20 |
| Last Update Date | 2017-06-29 |