| NPI | 1013303049 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207T00000X Neurological Surgery (Licence: NC 2023-01310) |
| Additional Taxonomies | 207T00000X Neurological Surgery (Licence: SC 90669) |
| Enumeration Date | 2015-04-07 |
| Last Update Date | 2024-03-20 |