| NPI | 1902874985 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207T00000X Neurological Surgery (Licence: VA 0101235918) |
| Additional Taxonomies | 207T00000X Neurological Surgery (Licence: DC MD034686) |
| Enumeration Date | 2006-03-08 |
| Last Update Date | 2021-07-08 |