| NPI | 1356404651 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 207T00000X Neurological Surgery (Licence: MI 4301509941) | 
| Additional Taxonomies | 207T00000X Neurological Surgery (Licence: VA 0101245824) | 
| 207T00000X Neurological Surgery (Licence: PA MD425186) | |
| 207T00000X Neurological Surgery (Licence: MA 235930) | |
| 207T00000X Neurological Surgery (Licence: DC MD038027) | |
| Enumeration Date | 2006-12-18 | 
| Last Update Date | 2023-11-02 |