| NPI | 1639445877 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207T00000X Neurological Surgery (Licence: CA C43254) |
| Additional Taxonomies | 207T00000X Neurological Surgery (Licence: LA MD.09654R) |
| 207T00000X Neurological Surgery (Licence: PR 8113) | |
| 207T00000X Neurological Surgery (Licence: NY 141769) | |
| 207T00000X Neurological Surgery (Licence: PA MD 028112 E) | |
| 207T00000X Neurological Surgery (Licence: ZZ 86/0431) | |
| Enumeration Date | 2012-03-30 |
| Last Update Date | 2012-03-30 |