| NPI | 1891006789 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207T00000X Neurological Surgery (Licence: PA MD463992) |
| Additional Taxonomies | 207T00000X Neurological Surgery (Licence: AZ R72011) |
| Enumeration Date | 2010-06-25 |
| Last Update Date | 2018-07-30 |