| NPI | 1356627350 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207T00000X Neurological Surgery (Licence: AR E11851) |
| Additional Taxonomies | 207T00000X Neurological Surgery (Licence: PA MD455714) |
| Enumeration Date | 2011-10-23 |
| Last Update Date | 2019-07-01 |