| NPI | 1013129584 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207T00000X Neurological Surgery (Licence: UT 7625702-1205) |
| Additional Taxonomies | 207T00000X Neurological Surgery (Licence: NY 244054) |
| 207T00000X Neurological Surgery (Licence: TX P0701) | |
| Enumeration Date | 2007-05-04 |
| Last Update Date | 2021-10-28 |