| NPI | 1457371809 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207T00000X Neurological Surgery (Licence: MD D0059392) |
| Additional Taxonomies | 207T00000X Neurological Surgery (Licence: PA MD052346L) |
| Enumeration Date | 2006-07-20 |
| Last Update Date | 2021-04-28 |