| NPI | 1972614626 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207T00000X Neurological Surgery (Licence: DC MD210002958) |
| Additional Taxonomies | 207T00000X Neurological Surgery (Licence: MO 2000157474) |
| Enumeration Date | 2006-08-31 |
| Last Update Date | 2023-06-24 |