| NPI | 1518233410 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207T00000X Neurological Surgery (Licence: PA MD479124) |
| Additional Taxonomies | 207T00000X Neurological Surgery (Licence: WI 75879-20) |
| 207T00000X Neurological Surgery (Licence: WA MD61076163) | |
| Enumeration Date | 2012-03-26 |
| Last Update Date | 2022-12-12 |