| NPI | 1518252196 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207T00000X Neurological Surgery (Licence: PA MD491401) |
| Additional Taxonomies | 207T00000X Neurological Surgery (Licence: VA 0101255632) |
| Enumeration Date | 2011-06-13 |
| Last Update Date | 2025-09-12 |