| NPI | 1376579383 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207T00000X Neurological Surgery (Licence: AL MD.32612) |
| Additional Taxonomies | 207T00000X Neurological Surgery (Licence: OR MD23327) |
| Enumeration Date | 2006-06-23 |
| Last Update Date | 2023-01-06 |