| NPI | 1457665648 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology Neurology (Licence: PA MD455206) |
| Additional Taxonomies | 207T00000X Neurological Surgery (Licence: IA R9034) |
| Enumeration Date | 2010-07-30 |
| Last Update Date | 2023-03-23 |