| NPI | 1902929714 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207T00000X Neurological Surgery (Licence: OR DO162805) |
| Additional Taxonomies | 207T00000X Neurological Surgery (Licence: MD H73704) |
| Enumeration Date | 2007-04-08 |
| Last Update Date | 2023-04-27 |