| NPI | 1992150999 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207T00000X Neurological Surgery (Licence: NC 218636) |
| Additional Taxonomies | 207T00000X Neurological Surgery (Licence: PA MD469599) |
| Enumeration Date | 2016-04-27 |
| Last Update Date | 2023-04-30 |