| NPI | 1013147107 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: GA 66519) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: CA c145705) |
| 207T00000X Neurological Surgery (Licence: CA C145705) | |
| Enumeration Date | 2009-07-23 |
| Last Update Date | 2023-08-08 |