| NPI | 1518130384 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207T00000X Neurological Surgery (Licence: PA MD458612) |
| Additional Taxonomies | 207T00000X Neurological Surgery (Licence: MA 390200000X) |
| Enumeration Date | 2008-04-11 |
| Last Update Date | 2017-01-23 |