| NPI | 1427252147 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207T00000X Neurological Surgery (Licence: WA MD60125290) |
| Additional Taxonomies | 207T00000X Neurological Surgery (Licence: PA MD422565) |
| Enumeration Date | 2007-06-14 |
| Last Update Date | 2023-12-18 |