| NPI | 1538572417 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207T00000X Neurological Surgery (Licence: PA MD473175) |
| Additional Taxonomies | 2084D0003X (Licence: PA MD473175) |
| Enumeration Date | 2014-06-09 |
| Last Update Date | 2022-03-15 |