| NPI | 1396996385 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207T00000X Neurological Surgery (Licence: DC MD040139) |
| Additional Taxonomies | 207T00000X Neurological Surgery (Licence: MD D0076394) |
| Enumeration Date | 2008-10-08 |
| Last Update Date | 2014-04-10 |