| NPI | 1548624406 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207T00000X Neurological Surgery (Licence: PA MD484059) |
| Additional Taxonomies | 207T00000X Neurological Surgery (Licence: WA MD61386507) |
| 207T00000X Neurological Surgery (Licence: PA FC2486620) | |
| Enumeration Date | 2016-04-07 |
| Last Update Date | 2024-06-19 |