| NPI | 1922286517 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207T00000X Neurological Surgery (Licence: MD D67880) |
| Additional Taxonomies | 207T00000X Neurological Surgery (Licence: UT 54124841205) |
| 207T00000X Neurological Surgery (Licence: VA 101252649) | |
| 207T00000X Neurological Surgery (Licence: MD D0067880) | |
| Enumeration Date | 2008-02-05 |
| Last Update Date | 2021-11-12 |