| NPI | 1417530163 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207T00000X Neurological Surgery (Licence: PA MD474607) |
| Additional Taxonomies | 207T00000X Neurological Surgery (Licence: PA MT222124) |
| Enumeration Date | 2021-04-30 |
| Last Update Date | 2023-05-15 |