| NPI | 1619078656 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207T00000X Neurological Surgery (Licence: PA MD458897) |
| Additional Taxonomies | 207T00000X Neurological Surgery (Licence: CO 50908) |
| 208600000X Surgery (Licence: MO T2001013358) | |
| Enumeration Date | 2006-09-25 |
| Last Update Date | 2020-10-19 |