| NPI | 1003041336 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207T00000X Neurological Surgery (Licence: TX R5418) |
| Additional Taxonomies | 207T00000X Neurological Surgery (Licence: RI MD15729) |
| Enumeration Date | 2009-05-15 |
| Last Update Date | 2023-09-26 |