| NPI | 1386643724 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207T00000X Neurological Surgery (Licence: PA MD472757) |
| Additional Taxonomies | 207T00000X Neurological Surgery (Licence: DC 32779) |
| Enumeration Date | 2005-07-19 |
| Last Update Date | 2021-02-19 |