| NPI | 1790771095 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2081N0008X Physical Medicine & Rehabilitation, Neuromuscular Medicine (Licence: OK 3110) |
| Additional Taxonomies | 207T00000X Neurological Surgery (Licence: OK 3110) |
| Enumeration Date | 2005-09-22 |
| Last Update Date | 2023-08-21 |