| NPI | 1649486069 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207T00000X Neurological Surgery (Licence: PA MD449927) |
| Additional Taxonomies | 207T00000X Neurological Surgery (Licence: MA 239111) |
| Enumeration Date | 2007-05-15 |
| Last Update Date | 2020-08-20 |