| NPI | 1003251554 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207T00000X Neurological Surgery (Licence: MA 290194) |
| Additional Taxonomies | 207T00000X Neurological Surgery (Licence: PA MD459587) |
| 207T00000X Neurological Surgery (Licence: TX S5244) | |
| Enumeration Date | 2013-05-09 |
| Last Update Date | 2021-09-29 |