| NPI | 1629206578 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207T00000X Neurological Surgery (Licence: OR MD184158) |
| Additional Taxonomies | 207T00000X Neurological Surgery (Licence: MN 53125) |
| Enumeration Date | 2009-06-30 |
| Last Update Date | 2022-07-21 |