| NPI | 1003015967 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207T00000X Neurological Surgery (Licence: TX P0208) |
| Additional Taxonomies | 207T00000X Neurological Surgery (Licence: MO 2003014735) |
| Enumeration Date | 2007-07-12 |
| Last Update Date | 2021-03-18 |