| NPI | 1770878993 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207T00000X Neurological Surgery (Licence: MD D87302) |
| Additional Taxonomies | 207T00000X Neurological Surgery (Licence: VA 0101283516) |
| Enumeration Date | 2011-06-15 |
| Last Update Date | 2024-08-15 |