| NPI | 1790130003 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207T00000X Neurological Surgery (Licence: MN 77668) |
| Additional Taxonomies | 207T00000X Neurological Surgery (Licence: DC MD210011509) |
| Enumeration Date | 2016-04-25 |
| Last Update Date | 2024-07-30 |