| NPI | 1912360173 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207T00000X Neurological Surgery (Licence: DC MD600003748) |
| Additional Taxonomies | 207T00000X Neurological Surgery (Licence: MI 4301508303) |
| 207T00000X Neurological Surgery (Licence: MD D0102959) | |
| 207T00000X Neurological Surgery (Licence: VA 0101285395) | |
| Enumeration Date | 2016-04-04 |
| Last Update Date | 2025-05-06 |