| NPI | 1477541456 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207T00000X Neurological Surgery (Licence: PA MD420830) |
| Additional Taxonomies | 207T00000X Neurological Surgery (Licence: SC 61330) |
| Enumeration Date | 2005-10-12 |
| Last Update Date | 2023-09-08 |