| NPI | 1962460907 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207T00000X Neurological Surgery (Licence: MA 227465) |
| Additional Taxonomies | 207T00000X Neurological Surgery (Licence: MD 68374) |
| Enumeration Date | 2006-05-01 |
| Last Update Date | 2020-05-27 |