| NPI | 1962424960 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207T00000X Neurological Surgery (Licence: PA MD453085) |
| Additional Taxonomies | 207T00000X Neurological Surgery (Licence: VA 0101240359) |
| Enumeration Date | 2006-07-25 |
| Last Update Date | 2014-11-13 |