| NPI | 1942269345 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207T00000X Neurological Surgery (Licence: SC 18584) |
| Additional Taxonomies | 207T00000X Neurological Surgery (Licence: NC 33156) |
| 207T00000X Neurological Surgery (Licence: VA 0101027911) | |
| 207T00000X Neurological Surgery (Licence: PA MD430194) | |
| Enumeration Date | 2006-03-23 |
| Last Update Date | 2013-02-20 |