| NPI | 1326010562 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207T00000X Neurological Surgery (Licence: PA MD065792L) |
| Additional Taxonomies | 174400000X Specialist (Licence: PA MD065792L) |
| Enumeration Date | 2006-02-02 |
| Last Update Date | 2022-12-12 |