| NPI | 1487037784 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207T00000X Neurological Surgery (Licence: SC 91758) |
| Additional Taxonomies | 207T00000X Neurological Surgery (Licence: IA MD-45592) |
| Enumeration Date | 2015-07-04 |
| Last Update Date | 2024-05-03 |