| NPI | 1003179425 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207T00000X Neurological Surgery (Licence: GA 82595) |
| Additional Taxonomies | 207T00000X Neurological Surgery (Licence: MN 56552) |
| Enumeration Date | 2012-06-20 |
| Last Update Date | 2020-03-02 |