| NPI | 1487683629 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207T00000X Neurological Surgery (Licence: MD D0061625) |
| Additional Taxonomies | 207T00000X Neurological Surgery (Licence: DC MD034883) |
| Enumeration Date | 2006-07-01 |
| Last Update Date | 2020-06-22 |