| NPI | 1013196070 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207T00000X Neurological Surgery (Licence: TX 45342) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: TX 45342) |
| Enumeration Date | 2007-10-26 |
| Last Update Date | 2021-12-03 |