| NPI | 1689011421 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207T00000X Neurological Surgery (Licence: OR MD198442) |
| Additional Taxonomies | 207T00000X Neurological Surgery (Licence: AL 42498) |
| 207T00000X Neurological Surgery (Licence: IA R-9660) | |
| Enumeration Date | 2013-06-03 |
| Last Update Date | 2024-02-01 |