| NPI | 1790888345 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207T00000X Neurological Surgery (Licence: PA MD451032) |
| Additional Taxonomies | 207T00000X Neurological Surgery (Licence: AR E-4155) |
| 207T00000X Neurological Surgery (Licence: MA 208193) | |
| 207T00000X Neurological Surgery (Licence: NH 12902) | |
| Enumeration Date | 2006-09-07 |
| Last Update Date | 2018-05-01 |