| NPI | 1770561979 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207T00000X Neurological Surgery (Licence: MD D26471) |
| Additional Taxonomies | 174400000X Specialist (Licence: MD D26471) |
| Enumeration Date | 2006-01-06 |
| Last Update Date | 2019-03-25 |