| NPI | 1699110502 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207T00000X Neurological Surgery (Licence: NM MD2021-0536) |
| Additional Taxonomies | 207T00000X Neurological Surgery (Licence: PA MD469588) |
| Enumeration Date | 2013-05-06 |
| Last Update Date | 2023-11-29 |