| NPI | 1659425916 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207T00000X Neurological Surgery (Licence: MD P20471) |
| Additional Taxonomies | 207T00000X Neurological Surgery (Licence: GA 070411) |
| Enumeration Date | 2007-01-23 |
| Last Update Date | 2017-11-27 |